Coverage of the external prostatic region by the hybrid method compared with the conventional method of prostate low‐dose‐rate brachytherapy: A randomized controlled study

Abstract

Objectives: To compare the dose evaluation parameters between conventional (using loose seed alone) and hybrid (using loose seeds in combination with stranded seeds) low-dose rate brachytherapy for prostate cancer. Methods: Between 2014 and July 2016, a total of 219 patients who underwent lowdose rate brachytherapy were enrolled in a randomized controlled trial (trial number: UMIN 000012780). Patients were randomized and allocated to two groups (conventional method vs hybrid method). Post-dosimetric parameters (%D90, minimal percentage of the dose received by 90% of the prostate gland; V100, percentage of the prostate volume receiving 100% of the prescribed minimal peripheral dose; V150, percentage of the prostate volume receiving 150% of the prescribed minimal peripheral dose; %UD30, minimal percentage of the dose received by 30% of the urethra; R100, rectal volume [mL] receiving 100% of the prescribed dose) calculated at 1 month after seed implantation by computed tomography scan were compared between the two groups, as well as the post-dosimetric parameters using the planning target volume of the prostate + 5-mm margin. Results: Regarding dose evaluation parameters, the prostate dose (%D90, V100, V150) and the urethral dose (%UD30) were not significantly different between the two groups, whereas V100 (+5-mm margin) and %D90 (+5-mm margin) were significantly higher in the hybrid method group compared with the conventional method group (P < 0.001). Conclusion: The present randomized study shows that the hybrid method of low-dose rate brachytherapy can achieve a higher coverage of the periprostatic region compared with the conventional method while maintaining an acceptable level of urethral and rectal doses.

Impact of neoadjuvant androgen deprivation therapy on postimplant prostate D90 and prostate volume after low‐dose‐rate brachytherapy for localized prostate cancer

“…LDR‐BT has been widely accepted as a definitive therapy option for localized PCa. Recently, there have been various LDR‐BT techniques, including preoperative versus intraoperative planning 16 and loose versus strand seed 17 . There is a consensus on the importance of high‐quality CT‐based postimplant dosimetry to improve the biochemical outcome after LDR‐BT 6–9,18,19 .…”