Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: dosimetrics and early clinical results

Lauche, O.; Delouya, Guila; Taussky, Daniel; Ménard, Cynthia; Béliveau-Nadeau, D.; Hervieux, Yannick; Larouche, R.; Barkati, Maroie

doi:10.5114/jcb.2016.59216

Cited by 14 publications

(7 citation statements)

References 20 publications

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“…This evolution has substantially improved workflow efficiencies (41), and was enabled by the technical development of 3D TRUS through new robotic aids and computational tools. Although depiction of prostate boundaries with TRUS is superior to that on CT, uncertainties remain at the anterior gland because of echogenic artifacts created by implanted catheters.…”

Section: Resultsmentioning

confidence: 99%

Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow

2017

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Magnetic resonance imaging (MRI) produces better soft tissue contrast than does ultrasonography (US) or computed tomography (CT) for visualizing male pelvic anatomy and prostate cancer. Better visualization of the tumor and organs at risk could allow better conformation of the dose to the target volumes while at the same time minimizing the dose to critical structures and the associated toxicity. Although the use of MRI for prostate brachytherapy would theoretically result in an improved therapeutic ratio, its implementation been slow, mostly because of technical challenges. In this review we describe the potential role of MRI at different steps in the treatment workflow for prostate brachytherapy: for patient selection, treatment planning, in the operating room, or for post-implant assessment. We further present the current clinical experience with MRI-guided prostate brachytherapy, both for permanent seed implantation and high-dose-rate brachytherapy.

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Section: Resultsmentioning

confidence: 99%

Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow

2017

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“…In cases of uncertain diagnosis repeat biopsies are required, adding significant delay before diagnosis can be obtained and a treatment chosen, and increasing risk for the patient. The new technique also shows great potential in interventional medicine applications beyond biopsies to optimize targeted treatment methods such as in laser-induced thermotherapy (LIIT) 46 , brachytherapy 47 , 48 or therapeutics injection of viruses into tumors.…”

Section: Discussionmentioning

confidence: 99%

A new method using Raman spectroscopy for in vivo targeted brain cancer tissue biopsy

Desroches

Jermyn

Pinto

et al. 2018

Sci Rep

171

150

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Modern cancer diagnosis requires histological, molecular, and genomic tumor analyses. Tumor sampling is often achieved using a targeted needle biopsy approach. Targeting errors and cancer heterogeneity causing inaccurate sampling are important limitations of this blind technique leading to non-diagnostic or poor quality samples, and the need for repeated biopsies pose elevated patient risk. An optical technology that can analyze the molecular nature of the tissue prior to harvesting could improve cancer targeting and mitigate patient risk. Here we report on the design, development, and validation of an in situ intraoperative, label-free, cancer detection system based on high wavenumber Raman spectroscopy. This optical detection device was engineered into a commercially available biopsy system allowing tumor analysis prior to tissue harvesting without disrupting workflow. Using a dual validation approach we show that high wavenumber Raman spectroscopy can detect human dense cancer with >60% cancer cells in situ during surgery with a sensitivity and specificity of 80% and 90%, respectively. We also demonstrate for the first time the use of this system in a swine brain biopsy model. These studies set the stage for the clinical translation of this optical molecular imaging method for high yield and safe targeted biopsy.

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“…While retrospective data report that the benefit of a HDR boost on cancer-specific mortality in intermediate and high-risk prostate cancer patients remains unclear [ 5 ], other reports show that a HDR boost following EBRT increases survival rates with few treatment-related toxicities [ 6 , 7 , 8 ]. Lauche et al [ 9 ] reported that the addition of a single-fraction HDR boost (15 Gy) to EBRT using real-time transrectal ultrasound (TRUS) planning provided high dosimetry quality with no patients experiencing ≥ 2 GI toxicity (follow-up 10 months). While previous reports also suggest that patients receiving EBRT plus HDR brachytherapy experience lower rates of incontinence and sexual dysfunction than patients receiving prostatectomy, they may experience chronic radiation proctitis with rectal wall bleeding up to two years after treatment [ 10 , 11 ].…”

Section: Purposementioning

confidence: 99%

What pelvic radiation disease symptoms are experienced by patients receiving external beam radiotherapy and a high-dose-rate brachytherapy boost for prostate cancer?

Halkett

Short

Aoun

et al. 2017

jcb

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PurposeResearch describing proctitis or pelvic radiation disease symptoms of prostate cancer patients one year after external beam radiotherapy (EBRT) plus high-dose-rate (HDR) brachytherapy is limited. This study aimed to assess prostate cancer patients’ pelvic radiation disease symptoms from baseline to 12 months post-radiotherapy.Material and methodsMen with prostate cancer referred for EBRT and HDR brachytherapy were recruited. Patients’ age, diagnosis, staging, PSA, past medical history, and treatment were recorded. Pelvic radiation disease symptoms were assessed via the Phase III EORTC proctitis module. Patients completed questionnaires before radiotherapy (baseline) and at one, three, six, and 12 months afterwards. To assess acute toxicity, symptoms one month after radiotherapy were compared with baseline. To assess post-treatment recovery, symptoms at three, six, and 12 months post radiotherapy were compared with one month. Symptom changes over time were assessed with linear mixed effect models.ResultsTwo hundred and sixty-six patients were recruited. Mean scores were below 2 at all time-points. The proportion of patients experiencing symptoms were also calculated. Linear mixed effect models showed that time-point, age, and T-stage were associated with some pelvic radiation disease symptoms.ConclusionsPatients receiving EBRT plus HDR brachytherapy to the prostate experienced mild pelvic radiation disease symptoms. Determining the proportion of patients with symptoms provided the most meaningful data.

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Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: dosimetrics and early clinical results

Cited by 14 publications

References 20 publications

Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow

Clinical use of magnetic resonance imaging across the prostate brachytherapy workflow

A new method using Raman spectroscopy for in vivo targeted brain cancer tissue biopsy

What pelvic radiation disease symptoms are experienced by patients receiving external beam radiotherapy and a high-dose-rate brachytherapy boost for prostate cancer?

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