Tumour and target volumes in permanent prostate brachytherapy: A supplement to the ESTRO/EAU/EORTC recommendations on prostate brachytherapy

Salembier, Carl; Lavagnini, Pablo; Nickers, Philippe; Mangili, P.; Rijnders, Alex; Polo, Alfredo; Venselaar, J.L.M.; Hoskin, Peter

doi:10.1016/j.radonc.2007.01.014

Cited by 243 publications

(163 citation statements)

References 81 publications

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“…A more standard approach to volume delineation should be an important aspect of quality assurance in prostate BT. 17 As stated by Morris et al 10 in their study, "dose metrics are not equivalent to oncologic end points and must be calibrated against disease-free survival using biochemical and clinical end points for each institution".…”

Section: Discussionmentioning

confidence: 99%

Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

Fellin¹,

Mirri²,

Santoro³

et al. 2016

BJR

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OBJECTIVE:\ud Low-dose-rate brachytherapy (LDR-BT) in localized prostate cancer is available since 15 years in Italy. We realized the first national multicentre and multidisciplinary data collection to evaluate LDR-BT practice, given as monotherapy, and outcome in terms of biochemical failure.\ud METHODS:\ud Between May 1998 and December 2011, 2237 patients with early-stage prostate cancer from 11 Italian community and academic hospitals were treated with iodine-125 ((125)I) or palladium-103 LDR-BT as monotherapy and followed up for at least 2 years. (125)I seeds were implanted in 97.7% of the patients: the mean dose received by 90% of target volume was 145 Gy; the mean target volume receiving 100% of prescribed dose (V100) was 91.1%. Biochemical failure-free survival (BFFS), disease-specific survival (DSS) and overall survival (OS) were estimated using Kaplan-Meier method. Log-rank test and multivariable Cox regression were used to evaluate the relationship of covariates with outcomes.\ud RESULTS:\ud Median follow-up time was 65 months. 5- and 7-year DSS, OS and BFFS were 99 and 98%, 94 and 89%, and 92 and 88%, respectively. At multivariate analysis, the National Comprehensive Cancer Network score (p < 0.0001) and V100 (p = 0.09) were correlated with BFFS, with V100 effect significantly different between patients at low risk and those at intermediate/high risk (p = 0.04). Short follow-up and lack of toxicity data represent the main limitations for a global evaluation of LDR-BT.\ud CONCLUSION:\ud This first multicentre Italian report confirms LDR-BT as an excellent curative modality for low-/intermediate-risk prostate cancer.\ud ADVANCES IN KNOWLEDGE:\ud Multidisciplinary teams may help to select adequately patients to be treated with brachytherapy, with a direct impact on the implant quality and, possibly, on outcome

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Section: Discussionmentioning

confidence: 99%

Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

Fellin¹,

Mirri²,

Santoro³

et al. 2016

BJR

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“…Radioactive seeds were included inside the phantom's prostate to simulate the assessment of the seed positioning during a clinical prostate brachytherapy treatment [1,13].…”

Section: Imaging a Prostate Brachytherapy Treatmentmentioning

confidence: 99%

Monte Carlo simulation of a realistic anatomical phantom described by triangle meshes: Application to prostate brachytherapy imaging

Badal

Kyprianou

Badano

et al. 2008

Radiotherapy and Oncology

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Purpose-Monte Carlo codes can simulate the transport of radiation within matter with high accuracy and can be used to study medical applications of ionising radiations. The aim of our work was to develop a Monte Carlo code capable of generating projection images of the human body. In order to obtain clinically realistic images a detailed anthropomorphic phantom was prepared. These two simulation tools are intended to study the multiple applications of imaging in radiotherapy, from image guided treatments to portal imaging.Methods-We adapted the general purpose code PENELOPE 2006 to simulate a radiation source, an ideal digital detector, and a realistic model of the patient anatomy. The anthropomorphic phantom was developed using computer-aided design tools, and is based on the NCAT phantom. The surface of each organ is modelled using a closed triangle mesh, and the full phantom contains 330 organs and more than 5 million triangles. A novel object-oriented geometry package, which includes an octree structure to sort the triangles, has been developed to use this complex geometry with PENELOPE.Results-As an example of the capabilities of the new code, projection images of the human pelvis region were simulated. Radioactive seeds were included inside the phantom's prostate. Therefore, the resulting simulated images resemble what would be obtained in a clinical procedure to assess the positioning of the seeds in a prostate brachytherapy treatment.Conclusions-The new code can produce projection images of the human body that are comparable to those obtained by a real imaging system (within the limitations of the anatomical phantom and the detector model). The simulated images can be used to study and optimise an imaging task (i.e., maximise the object detectability, minimise the delivered dose, find the optimum beam energy, etc.). Since PENELOPE can simulate radiation from 50 eV to 1 GeV, the code can also be used to simulate radiotherapy treatments and portal imaging. Using the octree data structure, the new Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. 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. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript geometry model does not significantly increase the computing time when compared to the simulation of a much simpler quadric geometry. In conclusion, we have shown that it is feasible to use PENELOPE and a complex triangle mesh geometry to simulate real medical physics applications.

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“…The maximum absorbed dose in the urethra was below the threshold doses of the value D 10 < 150% and D 30 < 130% of the prescription dose with both seeds. The D 2cc doses in the rectum were significantly lower than the threshold dose limit 145 Gy (24) . The doses in the most irradiated volumes of the rectum, starting from D 0.5cc , as well as in the bladder starting from D 7cc , are higher with the Pd-103 seeds than with I-125 seeds.…”

Section: Discussionmentioning

confidence: 75%

“…Figure 2 shows two sections of such a model. The seeds were positioned according to the modified uniform distribution proposed by Butler et al (24) , as shown on Figure 3. In total, 148 seeds were positioned in 24 applications, forming parallel lined-up segments in tangential direction to the pubic bones, on a spacing grid between segments of 1 cm, maintaining the seed spacing on a single segment of 6 mm between the centers of consecutive seeds.…”

Section: Methodsmentioning

confidence: 99%

Dosimetria comparativa de braquiterapia de próstata com sementes de I-125 e Pd-103 via SISCODES/MCNP

Trindade

Christóvão²,

Trindade

et al. 2012

Radiol Bras

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Objective: The present paper is aimed at presenting a comparative dosimetric study of prostate brachytherapy with I-125 and Pd-103 seeds. Materials and Methods: A protocol for both implants with 148 seeds was simulated on a heterogeneous three-dimensional pelvic phantom by means of the SISCODES/MCNP5 codes. Dose-volume histograms on prostate, rectum and bladder, dose indexes D 10 , D 30 , D 90 , D 0.5cc , D 2cc and D 7cc , and representations of the spatial dose distribution were evaluated. Results: For a D 90 index equivalent to the prescription dose, the initial activity of each I-125 seed was calculated as 0.42 mCi and of Pd-103 as 0.94 mCi. The maximum dose on the uretra was 90% and 108% of the prescription dose for I-125 and Pd-103, respectively. The D 2cc for I-125 was 30 Gy on the rectum and 127 Gy on the bladder; for Pd-103 was 29 Gy on the rectum and 189 Gy on the bladder. The D 10 on the pubic bone was 144 Gy for I-125 and 66 Gy for Pd-103. Conclusion: The results indicate that Pd-103 and I-125 implants could deposit the prescribed dose on the target volume. Among the findings of the present study, there is an excessive radiation exposure of the pelvic bones, particularly with the I-125 protocol. Keywords: Radiotherapy; Dosimetry; Prostate cancer; Brachytherapy; SISCODES; MCNP.Objetivo: O presente artigo visa apresentar um estudo dosimétrico comparativo de braquiterapia de próstata com sementes de I-125 e Pd-103. Materiais e Métodos: Um protocolo adotado para ambos os implantes com 148 sementes foi simulado em um fantoma tridimensional heterogêneo de pelve por meio dos códigos SISCODES/MCNP5. Histogramas dose-volume na próstata, bexiga e reto, índices de doses D 10 , D 30 , D 90 , D 0,5cc , D 2cc e D 7cc , e representações de distribuição espacial de dose foram avaliados. Resultados: A atividade inicial de cada semente de I-125, para que D 90 seja equivalente à dose de prescrição, foi calculada em 0,42 mCi, e de Pd-103, em 0,94 mCi. A dose máxima na uretra foi 90% e 108% da dose de prescrição para I-125 e Pd-103, respectivamente. A D 2cc para I-125 foi 30 Gy no reto e 127 Gy na bexiga, e para Pd-103 foi 29 Gy no reto e 189 Gy na bexiga. A D 10 no osso do púbis foi 144 Gy para I-125 e 66 Gy para Pd-103. Conclusão: Os resultados indicam que os implantes de Pd-103 e I-125 puderam depositar a dose prescrita no volume alvo. Entre os achados, observou-se excessiva exposição de radiação nos ossos da pelve, principalmente no protocolo com I-125. Unitermos: Radioterapia; Dosimetria; Câncer de próstata; Braquiterapia; SISCODES; MCNP. AbstractResumo

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Tumour and target volumes in permanent prostate brachytherapy: A supplement to the ESTRO/EAU/EORTC recommendations on prostate brachytherapy

Cited by 243 publications

References 81 publications

Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

Low dose rate brachytherapy (LDR-BT) as monotherapy for early stage prostate cancer in Italy: practice and outcome analysis in a series of 2237 patients from 11 institutions

Monte Carlo simulation of a realistic anatomical phantom described by triangle meshes: Application to prostate brachytherapy imaging

Dosimetria comparativa de braquiterapia de próstata com sementes de I-125 e Pd-103 via SISCODES/MCNP

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