Use of Gold Markers for Setup in Image-Guided Fractionated High-Dose-Rate Brachytherapy as a Monotherapy for Prostate Cancer

Ghadjar, Pirus; Gwerder, Nicole; Madlung, Axel; Behrensmeier, Frank; Thalmann, George N.; Mini, R.; Aebersold, Daniel M.

doi:10.1007/s00066-009-2007-7

Cited by 13 publications

(5 citation statements)

References 26 publications

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“…Brachytherapy allows for high-dose delivery within the prostate with sharp dose fall-off to the surrounding structures and sparing of the rectum and urinary bladder [9]. Different fractionation regimens (2-4 fractions), target volumes (tumor volume, prostate capsule, peripheral zone), and doses (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) Gy per fraction) have been previously described [3,11,14,15]. The application of brachytherapy needles is performed with the patient in the lithotomy position using spinal anesthesia.…”

Section: Introductionmentioning

confidence: 99%

“…The 3D preplan compensation of the dose distribution is limited because "hot" spots pose an imminent risk of increased toxicity. Since the quality of the implant correlates directly with the precision of needle positioning and the accuracy of target volume definition, additional deviations in needle positioning occur leading to dose failures in areas of the target volume [8,10,21].…”

Section: Introductionmentioning

confidence: 99%

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Advantage of robotic needle placement on a prostate model in HDR brachytherapy

et al. 2011

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By employing a prostate model, we showed for the first time that robot-assisted needle placement for HDR brachy-therapy is significantly more precise than the conventional method at a velocity of 2.7 mm/s. The robot-assisted needle positioning technique improves the degree of freedom by providing additional oblique insertion channels and could be potentially exploited not only for LDR but also for HDR brachytherapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Advantage of robotic needle placement on a prostate model in HDR brachytherapy

et al. 2011

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“…As a consequence, over the last few years, a number of alternative methods have been investigated. Optimal setup control would require the implantation of gold fiducial markers [11,13,20], but it is a cumbersome and invasive procedure. Ultrasound-based imaging has been recently introduced, but it may overestimate the daily prostate motion, particularly in the AP direction, negatively impacting prostate dose coverage and rectal sparing [22].…”

Section: Introductionmentioning

confidence: 99%

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

et al. 2011

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“…As previously described significant applicator shifts were detected and corrected and these shifts were not associated with the occurrence of GU toxicity [10]. However, we cannot exclude that some applicator shifts were not recognized contributing to impaired dosimetry and subsequently late GU toxicity.…”

Section: Resultsmentioning

confidence: 68%

Late toxicity and five year outcomes after high-dose-rate brachytherapy as a monotherapy for localized prostate cancer

et al. 2014

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BackgroundTo determine the 5-year outcome after high-dose-rate brachytherapy (HDR-BT) as a monotherapy.MethodsBetween 10/2003 and 06/2006, 36 patients with low (28) and intermediate (8) risk prostate cancer were treated by HDR-BT monotherapy. All patients received one implant and 4 fractions of 9.5 Gy within 48 hours for a total prescribed dose (PD) of 38 Gy. Five patients received concomitant androgen deprivation therapy (ADT). Toxicity was scored according to the common terminology criteria for adverse events from the National Cancer Institute (CTCAE) version 3.0. Biochemical recurrence was defined according to the Phoenix criteria and analyzed using the Kaplan Meier method. Predictors for late grade 3 GU toxicity were analyzed using univariate and multivariate Cox regression analyses.ResultsThe median follow-up was 6.9 years (range, 1.5-8.0 years). Late grade 2 and 3 genitourinary (GU) toxicity was observed in 10 (28%) and 7 (19%) patients, respectively. The actuarial proportion of patients with late grade 3 GU toxicity at 5 years was 17.7%. Late grade 2 and 3 gastrointestinal (GI) toxicities were not observed. The crude erectile function preservation rate in patients without ADT was 75%. The 5 year biochemical recurrence-free survival (bRFS) rate was 97%. Late grade 3 GU toxicity was associated with the urethral volume (p = 0.001) and the urethral V120 (urethral volume receiving ≥120% of the PD; p = 0.0005) after multivariate Cox regression.ConclusionsAfter HDR-BT monotherapy late grade 3 GU was observed relatively frequently and was associated with the urethral V120. GI toxicity was negligible, the erectile function preservation rate and the bRFS rate was excellent.

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Use of Gold Markers for Setup in Image-Guided Fractionated High-Dose-Rate Brachytherapy as a Monotherapy for Prostate Cancer

Abstract: Caudad position shifts up to 36 mm were observed. Gold markers represent a valuable tool to ensure setup accuracy and precise dose delivery in fractionated HDR-B monotherapy of prostate cancer.

Cited by 13 publications

References 26 publications

Advantage of robotic needle placement on a prostate model in HDR brachytherapy

Advantage of robotic needle placement on a prostate model in HDR brachytherapy

Prostate Image-Guided Radiotherapy by Megavolt Cone-Beam CT

Late toxicity and five year outcomes after high-dose-rate brachytherapy as a monotherapy for localized prostate cancer

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