ACR appropriateness criteria: Permanent source brachytherapy for prostate cancer

Davis, Brian J.; Taira, Al V.; Nguyen, Paul L.; Assimos, Dean G.; D’Amico, Anthony V.; Gottschalk, Alexander; Gustafson, Gary; Keole, Sameer R.; Liauw, Stanley L.; Lloyd, Shane; McLaughlin, Patrick W.; Movsas, Benjamin; Prestidge, Bradley R.; Showalter, Timothy N.; Vapiwala, Neha

doi:10.1016/j.brachy.2016.10.002

Cited by 26 publications

(14 citation statements)

References 87 publications

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“…The American College of Radiology Appropriateness Criteria for HDR brachytherapy does not list any recommended dosimetric constraints . This lies in opposition to LDR brachytherapy, where ACR Appropriateness criteria have a recommendation of a urethral V150 < 5% and rectal V100 < 1cc . Most studies looking at correlations are from series where HDR was used in combination with external beam radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

“…17 This lies in opposition to LDR brachytherapy, where ACR Appropriateness criteria have a recommendation of a urethral V150 < 5% and rectal V100 < 1cc. 18 Most studies looking at correlations are from series where HDR was used in combination with external beam radiation therapy. Akimoto et al 19 , for example, found that the urethral dose was the greatest determinant of acute urinary toxicity.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Ragab

Banerjee²,

Park

et al. 2017

J Med Imag Rad Onc

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Introduction: To identify differences in acute urinary and sexual toxicity between a 6-fraction and 2-fraction high-dose-rate brachytherapy monotherapy regimen and correlate dosimetric constraints to short-term toxicity. Methods: A single institution retrospective study of 116 men with prostate cancer treated with HDR monotherapy from 2010 to 2015 was conducted. Eighty-one men had 7.25 Gy 9 6-fractions and 35 men had 13.5 Gy 9 2-fractions. Patients had two CT-planned implants spaced 1-2 weeks apart. Patient baseline characteristics, International Prostate Symptom Scores (IPSS) and Sexual Health Inventory for Men (SHIM) scores were collected pre-treatment and 3, 6 and 12 months post-implantation. Mixed effect modelling was undertaken to compare baseline, 1-6 month and 7-12 month scores between groups. Poisson regression analysis was performed to correlate dosimetric constraints with acute toxicity. Results: There was no difference between baseline and post-implantation IPSS scores between 6-fraction and 2-fraction groups. SHIM scores for men treated with 6-fractions had a steeper decline at 1-6 months, but resolved at 7-12 months. Pre-treatment alpha-blocker use correlated with worse shortterm acute urinary toxicity. Worsened SHIM score correlated with increasing age, diabetes mellitus and androgen-deprivation therapy. In a dosimetric analysis of outcomes, prostate V150 dose and bladder wall (D01.cc, D1cc, D2cc) dose correlated with increased IPSS score. Conclusion: No increased acute genitourinary or sexual dysfunction has been observed in men when transitioning from 6-fraction to 2-fraction HDR monotherapy. A dosimetric correlation was found between the V150 and bladder wall doses for acute urinary toxicity. Future research should continue to standardize and validate dose constraints for prostate HDR monotherapy patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Ragab

Banerjee²,

Park

et al. 2017

J Med Imag Rad Onc

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“…8,23 Implementation of new treatment techniques is now possible due to MRI treatment planning. 8,23 Implementation of new treatment techniques is now possible due to MRI treatment planning.…”

Section: Resultsmentioning

confidence: 99%

“…The application of MRI in brachytherapy treatment planning has become more routine in treatment planning of pelvic malignancies, both in the realm of gynecologic 29 and genitourinary tumors. 8,23 Implementation of new treatment techniques is now possible due to MRI treatment planning. 30 which included 2350 cases of prostate focal therapy, revealed excellent short-and medium-term tumor control and incontinence and erectile dysfunction rates.…”

Section: Resultsmentioning

confidence: 99%

Comparison of multiparametric MRI‐based and transrectal ultrasound‐based preplans with intraoperative ultrasound‐based planning for low dose rate interstitial prostate seed implantation

Fredman

Traughber

Gross

et al. 2019

J Applied Clin Med Phys

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Purpose Transrectal ultrasound images are routinely acquired for low dose rate (LDR) prostate brachytherapy dosimetric preplanning (pTRUS), although diagnostic multiparametric magnetic resonance imaging (mpMRI) may serve this purpose as well. We compared the predictive abilities of TRUS vs MRI relative to intraoperative TRUS (iTRUS) to assess the role of mpMRI in brachytherapy preplanning. Materials and methods Retrospective analysis was performed on 32 patients who underwent iTRUS‐guided prostate LDR brachytherapy as either mono‐ or combination therapy. 56.3% had pTRUS‐only volume studies and 43.7% had both 3T‐mpMRI and pTRUS preplanning. MRI was used for preplanning and its image fusion with iTRUS was also used for intraoperative guidance of seed placement. Differences in gland volume, seed number, and activity and procedure time were examined, as well as the identification of lesions suspicious for tumor foci. Pearson correlation coefficient and Fisher's Z test were used to estimate associations between continuous measures. Results There was good correlation of planning volumes between iTRUS and either pTRUS or MRI (r = 0.89, r = 0.77), not impacted by the addition of hormonal therapy (P = 0.65, P = 0.33). Both consistently predicted intraoperative seed number (r = 0.87, r = 0.86). MRI/TRUS fusion did not significantly increase surgical or anesthesia time (P = 0.10, P = 0.46). mpMRI revealed suspicious focal lesions in 11 of 14 cases not visible on pTRUS, that when correlated with histopathology, were incorporated into the plan. Conclusions Relative to pTRUS, MRI yielded reliable preplanning measures, supporting the role of MRI‐only LDR treatment planning. mpMRI carries numerous diagnostic, staging and preplanning advantages that facilitate better patient selection and delivery of novel dose escalation and targeted therapy, with no additional surgical or anesthesia time. Prospective studies assessing its impact on treatment planning and delivery can serve to establish mpMRI as the standard of care in LDR prostate brachytherapy planning.

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“…Low‐dose‐rate prostate brachytherapy (LDR‐PB) using 125 I‐seed implants is a standard therapeutic approach for low‐risk localised prostate cancer and selected intermediate‐risk patients . Combined therapy, in the form of an LDR‐PB boost to external beam radiotherapy (EBRT) with or without androgen‐deprivation therapy (ADT), has been recommended as an option for the treatment of patients with prostate cancer with a high risk of disease relapse . These recommendations, based on large cohort series, are now supported by Level 1 Evidence from the Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (ASCENDE‐RT) randomised controlled trial .…”

Section: Introductionmentioning

confidence: 99%

Low‐dose‐rate brachytherapy for the treatment of localised prostate cancer in men with a high risk of disease relapse

Laing¹,

Uribe²,

Uribe-Lewis³

et al. 2018

BJU International

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LDR-PB is effective at controlling localised prostate cancer in patients with a high risk of disease relapse. As the present study was not randomised, it is not possible to define those patients who need the addition of ADT and/or EBRT. However, the NICE criteria appear suitable to define treatment options where patients could benefit from LDR-PB as monotherapy or combined treatment. This choice should be discussed with the patient taking into account comorbidities and presence of multiple high-risk factors.

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ACR appropriateness criteria: Permanent source brachytherapy for prostate cancer

Abstract: Updated appropriateness criteria for patient evaluation, selection, treatment, and postimplant dosimetry are given. These criteria are intended to be advisory only with the final responsibility for patient care residing with the treating clinicians.

Cited by 26 publications

References 87 publications

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Comparison of patient‐reported acute urinary and sexual toxicity scores in a 6‐ versus 2‐fraction course of high‐dose‐rate prostate brachytherapy monotherapy

Comparison of multiparametric MRI‐based and transrectal ultrasound‐based preplans with intraoperative ultrasound‐based planning for low dose rate interstitial prostate seed implantation

Low‐dose‐rate brachytherapy for the treatment of localised prostate cancer in men with a high risk of disease relapse

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