Single dose high-dose rate (HDR) brachytherapy (BT) as monotherapy for localised prostate cancer: Early results of a UK national cohort study

Tharmalingam, Hannah; Tsang, Y.; Ostler, Peter; Wylie, James; Bahl, Amit; Lydon, Anna; Ahmed, Imtiaz; Elwell, Christine; Nikapota, A.; Hoskin, Peter

doi:10.1016/j.radonc.2019.12.017

Cited by 26 publications

(17 citation statements)

References 35 publications

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“…Gastrointestinal and genitourinary toxicities in these studies were generally mild, with toxicities greater than grade 2 (variously according to RTOG and CTCAE criteria) very rarely observed. Whilst single fraction OAR dosimetric constraints are well-tolerated, evidence published since initiating the present study has shown poorer efficacy for a single dose of 19 Gy to the prostate, particularly for intermediate-and high-risk patients [11,12], therefore is not currently recommended for clinical implementation. We posit that the dosimetric constraints utilised in the present study for two fraction prostate SBRT are well-supported by the available clinical evidence and represent a suitable framework for future clinical trials.…”

Section: Discussionmentioning

confidence: 94%

“…As such, we propose that these two structures are propagated to the daily MR from imaging data previously delineated, via soft-tissue based rigid registration. Single HDR treatments have been proven to result in poorer biochemical relapse-free survival than would be achieved with standard fractionation [11,12]. Therefore, at present, single fraction SBRT no longer presents a promising line of study.…”

Section: Discussionmentioning

confidence: 99%

“…Single HDR treatments have been proven to result in poorer biochemical relapse-free survival than would be achieved with standard fractionation [11] , [12] . Therefore, at present, single fraction SBRT no longer presents a promising line of study.…”

Section: Discussionmentioning

confidence: 99%

“…More extreme hypofractionation has been tested with high dose rate (HDR) brachytherapy, down to 3, 2 or even a single fraction [7] , [8] , [9] with limited experience with similar fractionations delivered with external beam radiotherapy [10] . However, recently reported poor PSA control rates with single fraction HDR have significantly tempered enthusiasm for this approach [11] , [12] , [13] .…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of MR-guided ultrahypofractionated radiotherapy in 5, 2 or 1 fractions for prostate cancer

Mohajer

Dunlop

Mitchell

et al. 2021

Clinical and Translational Radiation Oncology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Feasibility of MR-guided ultrahypofractionated radiotherapy in 5, 2 or 1 fractions for prostate cancer

Mohajer

Dunlop

Mitchell

et al. 2021

Clinical and Translational Radiation Oncology

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“…Recently there have been attempts to further hypofractionate HDR-BT monotherapy for prostate cancer, with positive results down to a two-fraction treatment protocol [2]. Attempts to deliver an adequate radiation dose to the target in these ultra-hypofractionated treatments have increased stress on the neighboring organs at risk (OAR), and so far, attempts to go to a single fraction monotherapy treatment have shown discouraging results [3,4]. While generally, the focus is on increasing the physical radiation dose, an interesting alternative is to aim at increasing the biological effective dose (BED), with the focus on sensitizing the target more than the surrounding tissue and OAR.…”

Section: Introductionmentioning

confidence: 99%

Simultaneous ThermoBrachytherapy: Electromagnetic Simulation Methods For Fast And Accurate Adaptive Treatment Planning

Androulakis¹,

Mestrom²,

Christianen³

et al. 2022

Preprint

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The combination of interstitial hyperthermia treatment (IHT) with high dose rate brachytherapy (HDR-BT) for prostate cancer treatment and has the potential to improve clinical outcome, since it highly enhances the efficiency of cell kill, especially when applied simultaneously. Therefore, we have developed the ThermoBrachy applicators. To effectively apply optimal targeted IHT, treatment planning is considered essential. However, treatment planning in IHT is rarely applied since it is regarded difficult to accurately calculate the deposited energy in the tissue in a short enough time for clinical practice. In this study, we investigated various time-efficient methods for fast computation of the electromagnetic (EM) energy deposition resulting from the ThermoBrachy applicators. Initially, we investigated the use of an electro-quasistatic solver. Next, we extended our investigation to the application of geometric simplifications. Furthermore, we investigated the validity of the superpositioning principle, which can enable adaptive treatment plan optimization without the need for continuous recomputation of the EM field. Finally, we evaluated the accuracy of the methods by comparing them to the golden standard Finite-Difference Time-Domain calculation method using gamma-index analysis. The simplifications considerably reduced the computation time needed, improving from &gt;12 h to a few seconds. All investigated methods showed excellent agreement with the golden standard by showing a &gt;99% passing rate with 1%/0.5 mm Dose Difference and Distance-to-Agreement criteria. These results allow the proposed electromagnetic simulation method to be used for fast and accurate adaptive treatment planning.

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AAPM Task Group Report 267: A joint AAPM GEC‐ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy

Chen,

Li,

Brenner

et al. 2024

Medical Physics

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Brachytherapy utilizes a multitude of radioactive sources and treatment techniques that often exhibit widely different spatial and temporal dose delivery patterns. Biophysical models, capable of modeling the key interacting effects of dose delivery patterns with the underlying cellular processes of the irradiated tissues, can be a potentially useful tool for elucidating the radiobiological effects of complex brachytherapy dose delivery patterns and for comparing their relative clinical effectiveness. While the biophysical models have been used largely in research settings by experts, it has also been used increasingly by clinical medical physicists over the last two decades. A good understanding of the potentials and limitations of the biophysical models and their intended use is critically important in the widespread use of these models. To facilitate meaningful and consistent use of biophysical models in brachytherapy, Task Group 267 (TG‐267) was formed jointly with the American Association of Physics in Medicine (AAPM) and The Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GEC‐ESTRO) to review the existing biophysical models, model parameters, and their use in selected brachytherapy modalities and to develop practice guidelines for clinical medical physicists regarding the selection, use, and interpretation of biophysical models. The report provides an overview of the clinical background and the rationale for the development of biophysical models in radiation oncology and, particularly, in brachytherapy; a summary of the results of literature review of the existing biophysical models that have been used in brachytherapy; a focused discussion of the applications of relevant biophysical models for five selected brachytherapy modalities; and the task group recommendations on the use, reporting, and implementation of biophysical models for brachytherapy treatment planning and evaluation. The report concludes with discussions on the challenges and opportunities in using biophysical models for brachytherapy and with an outlook for future developments

show abstract

Single dose high-dose rate (HDR) brachytherapy (BT) as monotherapy for localised prostate cancer: Early results of a UK national cohort study

Cited by 26 publications

References 35 publications

Feasibility of MR-guided ultrahypofractionated radiotherapy in 5, 2 or 1 fractions for prostate cancer

Feasibility of MR-guided ultrahypofractionated radiotherapy in 5, 2 or 1 fractions for prostate cancer

Simultaneous ThermoBrachytherapy: Electromagnetic Simulation Methods For Fast And Accurate Adaptive Treatment Planning

AAPM Task Group Report 267: A joint AAPM GEC‐ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy

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