Brachytherapy: Where Has It Gone?

Petereit, Daniel G.; Frank, Steven J.; Viswanathan, Akila N.; Erickson, Beth; Eifel, Patricia J.; Nguyen, Paul L.; Wazer, David E.

doi:10.1200/jco.2014.59.8128

Cited by 112 publications

(59 citation statements)

References 23 publications

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“…In the future, brachytherapy should include personalized tools of medical oncology and radiology. Clinical evidence and technological refinements contrast with trends in brachytherapy use . Health care policies and insurance providers should be encouraged to optimize the organization of patient care to ensure that all patients have the opportunity to receive the standard treatment or can make a choice between available therapeutic options .…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy: An overview for clinicians

Chargari

Deutsch

Blanchard

et al. 2019

CA A Cancer J Clinicians

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Brachytherapy is a specific form of radiotherapy consisting of the precise placement of radioactive sources directly into or next to the tumor. This technique is indicated for patients affected by various types of cancers. It is an optimal tool for delivering very high doses to the tumor focally while minimizing the probability of normal tissue complications. Physicians from a wide range of specialties may be involved in either the referral to or the placement of brachytherapy. Many patients require brachytherapy as either primary treatment or as part of their oncologic care. On the basis of high-level evidence from randomized controlled trials, brachytherapy is mainly indicated: 1) as standard in combination with chemoradiation in patients with locally advanced cervical cancer; 2) in surgically treated patients with uterine endometrial cancer for decreasing the risk of vaginal vault recurrence; 3) in patients with high-risk prostate cancer to perform dose escalation and improve progression-free survival; and 4) in patients with breast cancer as adjuvant, accelerated partial breast irradiation or to boost the tumor bed. In this review, the authors discuss the clinical relevance of brachytherapy with a focus on indications, levels of evidence, and results in the overall context of radiation use for patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Brachytherapy: An overview for clinicians

Chargari

Deutsch

Blanchard

et al. 2019

CA A Cancer J Clinicians

Self Cite

210

125

View full text Add to dashboard Cite

show abstract

“…The reason for this is not clear. Multiple factors may be contributing to this trend including an incomplete understanding of the potential contributions of BT by CT organizers, a misconception that BT is an antiquated modality, numbers of radiation oncologists who are competent in BT to assist in CTs, insufficient reimbursement, or competition with other cancer therapies (5). Regardless of the cause, a continuation of the status quo will result in stagnant growth or a decline in the investigation, promotion, and use of BT.…”

Section: Discussionmentioning

confidence: 99%

“…BT use is declining in the United States. The rate of utilization of prostate BT was 17% in 2002, but by 2010 had decreased to 8% (4,5). Similarly, Han et al reported a 25% reduction in BT use in cervical cancer between 1988 and 2009.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive analysis of brachytherapy clinical trials over the past 15 years

et al. 2016

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“…The rate of prostate cancer control with permanent low dose rate (LDR) brachytherapy alone or in combination with external beam radiation therapy (EBRT) is excellent, and may provide superior disease control compared with EBRT in some patient subsets (2,3). As many as 30%-40% of prostate cancer patients will undergo LDR brachytherapy for treatment (4,5).…”

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confidence: 99%

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

Valle¹,

Greer²,

Shih³

et al. 2018

Diagn Interv Radiol

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PURPOSEProstate multiparametric magnetic resonance imaging (mpMRI) has utility in detecting post-radiotherapy local recurrence. We conducted a multireader study to evaluate the diagnostic performance of mpMRI for local recurrence after low dose rate (LDR) brachytherapy. METHODSA total of 19 patients with biochemical recurrence after LDR brachytherapy underwent 3T endorectal coil mpMRI with T2-weighted imaging, dynamic contrast-enhanced imaging (DCE) and diffusion-weighted imaging (DWI) with pathologic confirmation. Prospective reads by an experienced prostate radiologist were compared with reads from 4 radiologists of varying experience. Readers identified suspicious lesions and rated each MRI detection parameter. MRI-detected lesions were considered true-positive with ipsilateral pathologic confirmation. Inferences for sensitivity, specificity, positive predictive value (PPV), kappa, and index of specific agreement were made with the use of bootstrap resampling. RESULTSPathologically confirmed recurrence was found in 15 of 19 patients. True positive recurrences identified by mpMRI were frequently located in the transition zone (46.7%) and seminal vesicles (30%). On patient-based analysis, average sensitivity of mpMRI was 88% (standard error [SE], 3.5%). For highly suspicious lesions, specificity of mpMRI was 75% (SE, 16.5%). On lesion-based analysis, the average PPV was 62% (SE, 6.7%) for all lesions and 78.7% (SE, 10.3%) for highly suspicious lesions. The average PPV for lesions invading the seminal vesicles was 88.8% (n=13). The average PPV was 66.6% (SE, 5.8%) for lesions identified with T2-weighted imaging, 64.9% (SE, 7.3%) for DCE, and 70% (SE, 7.3%) for DWI. CONCLUSIONThis series provides evidence that mpMRI after LDR brachytherapy is feasible with a high patient-based cancer detection rate. Radiologists of varying experience demonstrated moderate agreement in detecting recurrence.You may cite this article as: Valle LF, Greer MD, Shih JH, et al. Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy. Diagn Interv Radiol 2018; 24: 46-53.

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Brachytherapy: Where Has It Gone?

Cited by 112 publications

References 23 publications

Brachytherapy: An overview for clinicians

Brachytherapy: An overview for clinicians

A comprehensive analysis of brachytherapy clinical trials over the past 15 years

Multiparametric MRI for the detection of local recurrence of prostate cancer in the setting of biochemical recurrence after low dose rate brachytherapy

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