Prostate brachytherapy

Ash, D; Bottomley, DM; Carey, BM

doi:10.1038/sj.pcan.4500238

Cited by 14 publications

(4 citation statements)

References 9 publications

(9 reference statements)

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“…These reports resulted in a renaissance for prostate BT. In 1977, Court and Chassangne (18) began treating prostate cancer with after-loading techniques, and since then several reports have been published (13,14,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Although the data presented were encouraging, no randomised study has been published, and there are criticisms concerning some of the BT treatment studies (29,30).…”

mentioning

confidence: 74%

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

Edgren

Ekelund²,

Albertsson³

et al. 2006

Int J Oncol

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Abstract. The aim of this study was to focus on certain characteristic problems associated with Iridium-192 high dose-rate brachytherapy in combination with external beam radiation therapy (EBRT) in the treatment of patients with localised prostate cancer. Over a period of 16 years, >2,000 patients with prostate cancer have been treated in Sweden with a combination of two fractions of 10 Gy Ir-192 HDR-BT and 50 Gy of fractionated EBRT. Although this treatment is usually well tolerated, there are biological and technical factors to be considered before and during the treatment of the patient to avoid side effects or under-treatment of the target volume. Some of the problems facing the doctors are transducer stability, needle deviation, target definition, target motion, pubic arch interference, concomitant diseases and tolerance doses for different organs at risk. These problems are discussed and possible solutions are presented in this study. IntroductionProstate cancer is the most common malignancy afflicting Swedish men (1,2). Annually, more than 9,000 new cases are diagnosed (3). Although health controls have been ardently discussed during recent years, no screening programmes have as yet been initiated in Scandinavia (4,5). Radiotherapy and radical prostatectomy are generally regarded as the two chief modalities suitable for curative intent treatment (6-12). The results of treatment by these modalities are equivalent, but the acute and long-term side effects which develop after the definitive treatment of prostate cancer differ. The main side effects after surgery are impotence and incontinence, while proctitis, colitis and cystitis are seen after radiotherapy (13).The advantage of brachytherapy (BT) is the short irradiation range. This minimises the dose to organs at risk in the neighbourhood of the target, even though therapy requires that the irradiation source is placed inside or very near the target.Prostate BT was first reported by Pasteau in 1911 (14). The complication rate was high, probably due to the application of the source through the urethra. In the years that followed, the treatment of prostate cancer has focused on radical prostatectomy and external beam radiation therapy (EBRT). However, two different techniques for obtaining a more homogeneous dose distribution in the prostate, which reduce the frequency of side effects, were reported by Flocks in 1964 (15), by Carlton (16) and by Whitmore et al in 1972 (17). These techniques utilized permanent implants of low doserate (LDR) Gold-198 and Iodine-125 isotopes, respectively. These reports resulted in a renaissance for prostate BT. In 1977, Court and Chassangne (18) began treating prostate cancer with after-loading techniques, and since then several reports have been published (13,14,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28). Although the data presented were encouraging, no randomised study has been published, and there are criticisms concerning some of the BT treatment studies (29,30). Randomised clinical trials are planned by national groups...

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confidence: 74%

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

Edgren

Ekelund²,

Albertsson³

et al. 2006

Int J Oncol

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“…Brachytherapy is an option suitable for men with smaller prostates who may choose any other radical treatment, including patients who are not suitable for surgery (Ash et al, 1998). The use of brachytherapy in general has become more common throughout Europe (Guedea et al, 2007).…”

Section: Treatment Optionsmentioning

confidence: 99%

Trends in non-metastatic prostate cancer management in the Northern and Yorkshire region of England, 2000–2006

et al. 2009

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Background:Our objective was to analyse variation in non-metastatic prostate cancer management in the Northern and Yorkshire region of England.Methods:We included 21 334 men aged ⩾55, diagnosed between 2000 and 2006. Principal treatment received was categorised into radical prostatectomy (11%), brachytherapy (2%), external beam radiotherapy (16%), hormone therapy (42%) and no treatment (29%).Results:The odds ratio (OR) for receiving a radical prostatectomy was 1.53 in 2006 compared with 2000 (95% CI 1.26–1.86), whereas the OR for receiving hormone therapy was 0.57 (0.51–0.64). Age was strongly associated with treatment received; radical treatments were significantly less likely in men aged ⩾75 compared with men aged 55–64 years, whereas the odds of receiving hormone therapy or no treatment were significantly higher in the older age group. The OR for receiving radical prostatectomy, brachytherapy or external beam radiotherapy were all significantly lower in the most deprived areas when compared with the most affluent (0.64 (0.55–0.75), 0.32 (0.22–0.47) and 0.83 (0.74–0.94), respectively) whereas the OR for receiving hormone therapy was 1.56 (1.42–1.71).Conclusions:This study highlights the variation and inequalities that exist in the management of non-metastatic prostate cancer in the Northern and Yorkshire region of England.

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“…Prostate brachytherapy is a form of radiation therapy in which about 80 to 100 radioactive seeds ͑e.g., 125 I or 103 Pd͒ are placed permanently into the prostate. 254,255 Because the control rates of prostate cancer appear to be dose dependent, it is theorized that the higher doses produced by brachytherapy will yield higher control rates than external-beam radiation without a rise in complications. In the past decade, removable implant techniques have been developed and used in some institutions.…”

Section: Xiva2 Transrectal Us "Trus…-guided Permanent Implant Prostate Brachytherapymentioning

confidence: 99%

Anniversary Paper: Evolution of ultrasound physics and the role of medical physicists and the AAPM and its journal in that evolution

Carson

Fenster

2009

Medical Physics

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Ultrasound has been the greatest imaging modality worldwide for many years by equipment purchase value and by number of machines and examinations. It is becoming increasingly the front end imaging modality; serving often as an extension of the physician's fingers. We believe that at the other extreme, high-end systems will continue to compete with all other imaging modalities in imaging departments to be the method of choice for various applications, particularly where safety and cost are paramount. Therapeutic ultrasound, in addition to the physiotherapy practiced for many decades, is just coming into its own as a major tool in the long progression to less invasive interventional treatment. The physics of medical ultrasound has evolved over many fronts throughout its history. For this reason, a topical review, rather than a primarily chronological one is presented. A brief review of medical ultrasound imaging and therapy is presented, with an emphasis on the contributions of medical physicists, the American Association of Physicists in Medicine (AAPM) and its publications, particularly its journal Medical Physics. The AAPM and Medical Physics have contributed substantially to training of physicists and engineers, medical practitioners, technologists, and the public.

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Prostate brachytherapy

Cited by 14 publications

References 9 publications

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

High dose-rate brachytherapy of prostate cancer utilising Iridium-192 after-loading technique: Technical and methodological aspects

Trends in non-metastatic prostate cancer management in the Northern and Yorkshire region of England, 2000–2006

Anniversary Paper: Evolution of ultrasound physics and the role of medical physicists and the AAPM and its journal in that evolution

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