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:10.1016/j.canrad.2016.08.084

Cited by 1 publication

(1 citation statement)

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“…Studies using a 15 Gy implant use a V 150 (or V 22.5 Gy ) dose constraint of up to 40%. 20,21 However, when interpolating the dose constraints from a 19 Gy plan, using the V 19 Gy , V 28.5 Gy , and V 38 Gy constraints, V 22.5 Gy can be estimated at around 61% (this value is not published but is calculated using interpolation of known dose constraints). 19 Therefore, V 22.5 Gy can likely be safely increased to 40% to 55%.…”

Section: Plan Optimization Methodsmentioning

confidence: 99%

Individualized Dose-Escalation of HDR Prostate Brachytherapy Implant to Decrease Required External Beam Radiation Dose: A Retrospective Feasibility Study

Dahn

Oliver

Allen

et al. 2019

Advances in Radiation Oncology

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PurposeHigh-dose-rate brachytherapy (HDR-BT) is commonly combined with external beam radiation therapy (EBRT) for the treatment of localized prostate cancer. Escalating the HDR-BT dose as far as organ-at-risk (OAR) constraints allow, on a personalized basis, would allow for a reduction in EBRT dose while achieving similar total biologic equivalence. The primary objective of this study was to determine the dosimetric feasibility of escalating the HDR-BT dose from 15 Gy to 16 or 17 Gy while continuing to meet OAR constraints from the original 15 Gy plan on an individualized basis.Methods and materialsA total of 53 consecutive HDR-BT plans were retrospectively assessed to determine what percentage of plans could be reoptimized to deliver a dose of 16 Gy or 17 Gy, while meeting defined 15-Gy OAR constraints. Factors independently associated with dose escalation were examined.ResultsThirty-nine plans (74%) and 2 plans (4%) were successfully escalated to a dose of 16 Gy and 17 Gy, respectively. Rectum V80 and urethra Dmax were independently predictive of the ability to dose escalate to 16 Gy.ConclusionsIndividualized HDR-BT dose escalation beyond 15 Gy without compromising OAR constraints is dosimetrically feasible. This approach could allow for a corresponding reduction of EBRT fractions (ie, from 15 to 12 fractions) and would be beneficial in terms of resource savings for departments, convenience for patients, and potentially better tolerance of treatment with the expected reduction in biologically equivalent doses to OARs. A clinical trial is being developed to investigate the efficacy and tolerance of personalized HDR-BT/EBRT dose fractionation for localized intracapsular prostate cancer.

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Section: Plan Optimization Methodsmentioning

confidence: 99%