Curiethérapie de haut débit de dose après radiothérapie externe d’un cancer de prostate : impact de la courbe d’apprentissage sur la dosimétrie

Benhaïm, C.; Chand, Marie-Eve; Gal, Jocelyn; Hijazi, Hussam; Gautier, Mathieu; Hannoun-Lévi, J.-M.

doi:10.1016/j.canrad.2014.04.008

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…Finally, it has been shown that dosimetric quality of HDRBT boost using CT-based planning was significantly improved during the learning curve period [ 19 ]. Similarly, catheter localization under TRUS guidance and prostate contouring may be sometimes difficult for untrained physicians because of bright echoes [ 20 ] and the learning curve when contouring on ultrasound as most radiation oncologists are trained using CT for planning.…”

Section: Discussionmentioning

confidence: 99%

Single-fraction high-dose-rate brachytherapy using real-time transrectal ultrasound based planning in combination with external beam radiotherapy for prostate cancer: dosimetrics and early clinical results

Lauche

Delouya

Taussky

et al. 2016

jcb

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PurposeTo validate the feasibility of a single-fraction high-dose-rate brachytherapy (HDRBT) boost for prostate cancer using real-time transrectal ultrasound (TRUS) based planning.Material and methodsFrom August 2012 to September 2015, 126 patients underwent a single-fraction HDRBT boost of 15 Gy using real-time TRUS based planning. External beam radiation therapy (EBRT) (37.5 Gy/15 fractions, 44 Gy/22 fractions, or 45 Gy/25 fractions) was performed before (31%) or after (69%) HDRBT boost. Genito-urinary (GU) and gastro-intestinal (GI) toxicity were assessed 4 and 12 months after the end of combined treatment using the international prostate symptom score scale (IPSS) and the common terminology criteria for adverse events (CTCAE) v3.0.ResultsAll dose-planning objectives were achieved in 90% of patients. Prostate D90 ≥ 105% and ≤ 115% was achieved in 99% of patients, prostate V150 ≤ 40% in 99%, prostate V200 < 11% in 96%, urethra D10 < 120% for 99%, urethra V125 = 0% in 100%, and rectal V75 < 1 cc in 93% of patients. Median IPSS score was 4 at baseline and did not change at 4 and 12 months after combined treatment. No patients developed ≥ grade 2 GI toxicity. With a median follow-up of 10 months, only two patients experienced biochemical failure. Among patients who didn't receive ADT, cumulative percentage of patients with PSA ≤ 1 ng/ml at 4 and 18 months was respectively 23% and 66%.ConclusionsSingle-fraction HDRBT boost of 15 Gy using real-time TRUS based planning achieves consistently high dosimetry quality. In combination with EBRT, toxicity outcomes appear promising. A longer follow-up is needed to assess long-term outcome and toxicities.

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Section: Discussionmentioning

confidence: 99%