Focal high-dose-rate brachytherapy for localized prostate cancer: toxicity and preliminary biochemical results

Prada, Pedro J.; Cardenal, Juan; Blanco, Ana; Andreescu, Jon; Ferri, María; Anchuelo, J.; Cerio, I. Diaz de; Sierrasesumaga, Nicolas; Vázquez, Andrés; Pacheco, Maite; Arrebola, S. Ruiz

doi:10.1007/s00066-019-01561-3

Cited by 17 publications

(12 citation statements)

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“…The operator dependence of TRUS image acquisition is another possible source of variation, which was not addressed in the current study and has to be investigated separately. A similar learning curve as described for TRUS-based prostate brachytherapy can be assumed for TRUS in LACC brachytherapy [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Hybrid TRUS/CT with optical tracking for target delineation in image-guided adaptive brachytherapy for cervical cancer

et al. 2020

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Objective To prospectively compare the interobserver variability of combined transrectal ultrasound (TRUS)/computed tomography (CT)- vs. CT only- vs. magnetic resonance imaging (MRI) only-based contouring of the high-risk clinical target volume (CTVHR) in image-guided adaptive brachytherapy (IGABT) for locally advanced cervical cancer (LACC). Methods Five patients with LACC (FIGO stages IIb–IVa) treated with radiochemotherapy and IGABT were included. CT, TRUS, and T2-weighted MRI images were performed after brachytherapy applicator insertion. 3D-TRUS image acquisition was performed with a customized ultrasound stepper device and software. Automatic applicator reconstruction using optical tracking was performed in the TRUS dataset and TRUS and CT images were fused with rigid image registration with the applicator as reference structure. The CTVHR (based on the GEC-ESTRO recommendations) was contoured by five investigators on the three modalities (CTVHR_CT, CTVHR_TRUS-CT, and CTVHR_MRI). A consensus reference CTVHR_MRI (MRIref) was defined for each patient. Descriptive statistics and overlap measures were calculated using RTslicer (SlicerRT Community and Percutaneous Surgery Laboratory, Queen’s University, Canada), comparing contours of every observer with one another and with the MRIref. Results The interobserver coefficient of variation was 0.18 ± 0.05 for CT, 0.10 ± 0.04 for TRUS-CT, and 0.07 ± 0.03 for MRI. Interobserver concordance in relation to the MRIref expressed by the generalized conformity index was 0.75 ± 0.04 for MRI, 0.51 ± 0.10 for TRUS-CT, and 0.48 ± 0.06 for CT. The mean CTVHR_CT volume of all observers was 71% larger than the MRIref volume, whereas the mean CTVHR_TRUS-CT volume was 15% larger. Conclusion Hybrid TRUS-CT as an imaging modality for contouring the CTVHR in IGABT for LACC is feasible and reproducible among multiple observers. TRUS-CT substantially reduces overestimation of the CTVHR volume of CT alone while maintaining similar interobserver variability.

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Section: Discussionmentioning

confidence: 99%

Hybrid TRUS/CT with optical tracking for target delineation in image-guided adaptive brachytherapy for cervical cancer

et al. 2020

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“…26,28,[30][31][32][34][35][36][37]40,41 Erectile function preservation rates were reported from 52% to 86%. 11,28,[30][31][32][34][35][36][37]40 Other methods Prada et al 44 reported focal high-dose rate (HDR) brachytherapy with 50 patients, and that HDR focal brachytherapy in selected patients with low-intermediate-risk PCa could achieve a comparable relapse-free survival to conventional whole prostate brachytherapy with less toxicity.…”

Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

Focal therapy of localized prostate cancer

Fujihara

Ukimura

2022

Int J of Urology

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In the treatment of localized prostate cancer, controlling the cancer and maintaining quality of life are important. Focal therapy of localized prostate cancer aims to treat the lesion/part of the prostate that includes the index lesion, which determines the prognosis. We performed a non‐systematic review of novel studies on focal therapy of localized prostate cancer as primary treatment published between 2016 and 2021. For mainly intermediate‐risk patients, therapeutic technology, such as cryoablation, brachytherapy, high‐intensity focused ultrasound, photodynamic therapy, microwave‐coagulation, electroporation, and laser ablation, etc., were performed. These procedures are minimally invasive and safe, and provide good functional outcome: a 94–100% pad‐free rate against urinary incontinence and 47–86% erectile function, which is sufficient for sexual intercourse. Accurate three‐dimensional mapping of the targeted lesion could be an essential navigation technique for therapeutic success. Intermediate‐ to short‐term oncological outcomes were good, resulting in downstaging of the patient's status to no clinically significant cancer; however, transition to conventional whole‐gland treatment was necessary in about 10–30% of patients. It is important to select appropriate patients by both multiparametric magnetic resonance imaging and targeted biopsy, and to follow‐up postoperatively with methods such as active surveillance. Clinically significant prostate‐specific antigen reduction, image response using preoperative and postoperative multiparametric magnetic resonance imaging, and histological analysis should be combined for follow‐up.

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“…Similar to other focal therapies, there have been promising results using focal radiotherapy approaches, such as focal brachytherapy and focal external-beam radiation therapy (EBRT) [94,95], although comparative trials against radical treatments are still missing. Nevertheless, radical radiotherapy has seen much improvement in the past years, with advances in MRIguided radiotherapy and ultra-hypofractionation that lead to better targeting of the tumour [96,97].…”

Section: B2b: Prostate Cancer Summarymentioning

confidence: 99%