Prostate specific antigen findings and biopsy results following interactive ultrasound guided transperineal brachytherapy for early stage prostate carcinoma

Stock, Richard G.; Stone, Nelson N.; DeWyngaert, J. Keith; Lavagnini, Pablo; Unger, Pamela

doi:10.1002/(sici)1097-0142(19960601)77:11<2386::aid-cncr30>3.0.co;2-r

Cited by 124 publications

(32 citation statements)

References 36 publications

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“…This cohort of patients includes all of those followed for more than 5 years and is our best estimate of the monotherapy prostate implant doses actually administered to the patients included in published retrospective reviews assessing clinical outcomes. 21,22 Therefore, a prescribed dose of 124 Gy best reproduces the evaluated clinical experience based solely on the limited physical issues addressed by this report. However, a large cohort of patients treated between 1997 and the present time have received a larger average dose 135 Gy for the same prescribed dose of 115 Gy.…”

Section: /D 95dtnnsmentioning

confidence: 85%

Recommendations of the American Association of Physicists in Medicine on interstitial source calibration and dosimetry: Implications for dose specification and prescription

Williamson¹,

Coursey

DeWerd

et al. 2000

Medical Physics

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The National Institute of Standards and Technology (NIST) introduced a national standard for air kerma strength of the ThreaSeed Model 200 103Pd source (the only 103Pd seed available until 1999) in early 1999. Correct implementation of the NIST-99 standard requires the use of dose rate constants normalized to this same standard. Prior to the availability of this standard, the vendor's calibration procedure consisted of intercomparing Model 200 seeds with a 109Cd source with a NIST-traceable activity calibration. The AAPM undertook a comprehensive review of 103Pd source dosimetry including (i) comparison of the vendor and NIST-99 calibration standards; (ii) comparison of original Task Group 43 dosimetry parameters with more recent studies; (iii) evaluation of the vendor's calibration history; and (iv) evaluation of administered-to-prescribed dose ratios from the introduction of 103Pd sources in 1987 to the present. This review indicates that for a prescribed dose of 115 Gy, the administered doses were (a) 124 Gy for the period 1988-1997 and (b) 135 Gy for the period 1997-1999. The AAPM recommends that the following three steps should be undertaken concurrently to implement correctly the 1999 dosimetry data and NIST-99 standard for 103Pd source: (1) the vendor should provide calibrations in terms of air kerma strength traceable to NIST-99 standard, (2) the medical physicist should update the treatment planning system with properly normalized (to NIST-99) dosimetry parameters for the selected 103Pd source model, and (3) the radiation oncologist in collaboration with the medical physicist should decide which clinical experience they wish to duplicate; the one prior to 1997 or the one from 1997 to 1999. If the intent is to duplicate the experience prior to 1997, which is backed by the long-term follow-up and published outcome studies, then the prior prescriptions of 115 Gy should be replaced by 124 Gy to duplicate that experience.

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Section: /D 95dtnnsmentioning

confidence: 85%

Recommendations of the American Association of Physicists in Medicine on interstitial source calibration and dosimetry: Implications for dose specification and prescription

Williamson¹,

Coursey

DeWerd

et al. 2000

Medical Physics

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“…While the long-term side effects of interstitial implantation of the prostate gland have been reported from several centers [1][2][3][4], the acute morbidity has not been fully studied. Both obstructive and irritative symptoms can result from radiation-related prostatitis and urethritis.…”

Section: Discussionmentioning

confidence: 99%

“…The advantages of interstitial implantation of the prostate in the treatment of prostate carcinoma derive from the rapid falloff of dose to surrounding structures. Due to this fact, implantation has been associated with low rates of stress incontinence, impotence, and rectal complications [1][2][3][4]. Prostate brachytherapy differs from external beam irradiation in that it delivers higher doses of radiation continuously over a longer time period and, therefore, may be associated with its own unique tox- icities.…”

Section: Introductionmentioning

confidence: 99%

Acute urinary morbidity following I‐125 interstitial implantation of the prostate gland

Desai

Stock

Stone

et al. 1998

Radiat. Oncol. Investig.

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SUMMARY The objective of this paper was to evaluate the acute urinary morbidity associated with I-125 interstitial implantation of the prostate gland. From 1991-1995, 117 patients underwent ultrasound (U/S)-guided implantation of the prostate gland. Median dose to 90% of the gland (d90) was 14.68 Gy (range = 1.65-21.75 Gy). The patients' urinary symptoms were recorded pre-implantation and at regular intervals after implantation using the International Prostate Symptom Score (IPSS), a self-assessment questionnaire in which patients scored 7 symptoms: incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia. Median follow-up was 12 months. The natural history of implant-related urinary symptoms was assessed in this manner. In addition, dosimetric factors including U/S prostate volume, total activity, activity per seed, dose volume histogram (DVH) values for dose to gland, and dose area histogram (DAH) values for dose to urethra and bladder were examined for correlation to the severity of each symptom as well as to total IPSS (sum of the individual symptom scores). Total IPSS peaked at 1 month post-implant and gradually returned to approximately baseline at 24 months. Total IPSS directly correlated with total activity and DVH for the prostate. Total IPSS, however, did not correlate with bladder or urethral DAH. With the exception of frequency, individual symptoms did not correlate with dose to gland, bladder, or urethra. Frequency scores did, however, correlate not only with dose to prostate gland but also dose to urethra. The acute urinary side effects of I-125 prostate implantation are transient and peak at 1 month post-implant. The severity of the urinary irritative symptoms developed are closely related to total dose to the gland. Urethral dose appears to affect frequency most significantly. Urinary symptoms, therefore, may be a limiting factor when considering dose escalation with I-125.

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“…The uniform seed loading (Quimby technique) provides for a very high central dose which is probably not needed for cancer eradication. It has been subsequently shown that by keeping the central dose lower-as with the peripheral source loading method (Parker-Patterson technique)-the comparative morbidity in TURP patients is markedly reduced [18][19][20][21][22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Brachytherapy for clinically localized prostate cancer: Results at 7- and 8-year follow-up

Ragde

Blasko

Grimm³

et al. 1997

Semin. Surg. Oncol.

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In recent years, there has been a resurgence of interest in interstitial radiation as a cost‐effective and efficient method of treating organ‐confined prostate cancer. We describe our 7‐ and 8‐year results with transperineal Iodine‐125 and Palladium‐103 implantation. A total of 551 consecutive patients were treated. Of these, 320/551 (58%) received implant alone (Group I), and 231/551 (42%)—considered higher risk patients—were also treated with a modest dose (45 Gy) of external beam irradiation (Group II). The median follow‐up for Group I was 55 months, and for Group II, 60 months. At 7 years, the actuarial freedom from biochemical failure (prostate‐specific antigen (PSA)≤ 1.0 ng/mL) was 80% in Group I patients, and, at 8 years, 65% in Group II patients. Morbidity was minimal if patients had not undergone prior transurethral prostate resections. The results indicate that interstitial radiation is a valid treatment for clinically localized prostate cancer. Semin. Surg. Oncol. 13:438‐443, 1997. © 1997 Wiley‐Liss, Inc.

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Prostate specific antigen findings and biopsy results following interactive ultrasound guided transperineal brachytherapy for early stage prostate carcinoma

Abstract: BACKGROUND.Interactive, transrectal, ultrasound-guided transperineal implantation is a new technique for performing permanent brachytherapy implants of the

Cited by 124 publications

References 36 publications

Recommendations of the American Association of Physicists in Medicine on interstitial source calibration and dosimetry: Implications for dose specification and prescription

Recommendations of the American Association of Physicists in Medicine on interstitial source calibration and dosimetry: Implications for dose specification and prescription

Acute urinary morbidity following I‐125 interstitial implantation of the prostate gland

Brachytherapy for clinically localized prostate cancer: Results at 7- and 8-year follow-up

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