Rectal dose constraints for salvage iodine-125 prostate brachytherapy

Peters, Max; Hoekstra, C.J.M.; Zyp, Jochem R.N. van der Voort van; Westendorp, R.; Pol, Sandrine M.G. van de; Moerland, Marinus A.; Kattevilder, Rob; Vulpen, Marco van

doi:10.1016/j.brachy.2015.10.004

Cited by 21 publications

(13 citation statements)

References 34 publications

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“…Additionally, some of the studies have correlated the mid and low-mid dose regions with late rectal bleeding [28,30,32,33] and stool frequency/urgency/tenesmus [26,30,32,37] respectively. Consequently, the mid-high rectum doses in prostate EBRT are typically managed through constraints on the V 40-75 Gy [28,46] whereas treatments involving prostate brachytherapy (HDR or LDR) should consider the high rectum doses via the V 70%-100% , D 1cc , D 2cc and/or near maximum dose [4,[47][48][49] due to high-dose hot spots associated with radioactive sources. For treatments involving prostate HDR, the importance of low-dose regions has been explained in terms of considerable inter-patient variation in rectal gas and the distance from the prostate to the anterior rectal wall [45].…”

Section: Discussionmentioning

confidence: 99%

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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Background: Derivation of dose-volume correlated with toxicity for multi-modal treatments can be difficult due to the perceived need for voxel-by-voxel dose accumulation. With data available for a single-institution cohort with long follow-up, an investigation was undertaken into rectal dose-volume effects for gastrointestinal toxicities after deformably-registering each phase of a combined external beam radiotherapy (EBRT)/high-dose-rate (HDR) brachytherapy prostate treatment.

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Section: Discussionmentioning

confidence: 99%

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

et al. 2016

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“…Thus, even if the volume of rectum reirradiated with sPPI is lower with a focal treatment, the risk to the rectum could be similar to that with whole-gland sPPI, especially if the lesion index is located in the peripheral zone, posteriorly. In whole-gland sPPI, Peters et al (29) recently recommended a rectal D 2cc ! 100 Gy.…”

Section: Discussionmentioning

confidence: 99%

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

et al. 2016

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“…For the 1 st salvage LDR-BT treatment, dose restrictions for bladder, urethra, and rectum have been published to minimize the risk of late severe toxicity [20, 21], namely a bladder D 2cc < 70 Gy, a urethral V 100 < 0.4 cc and a rectal D 0.1cc < 160 Gy. Unfortunately, no such restrictions are available for salvage HDR-BT [11].…”

Section: Discussionmentioning

confidence: 99%

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

Maenhout

Vulpen

Moerland

et al. 2017

jcb

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PurposeSalvage treatments for localized radiorecurrent prostate cancer can be performed safely when a focal and image guided approach is used. Due to the low toxicity, the opportunity exists to investigate a second salvage treatment when a second locally recurrent prostate cancer occurs. Here, we describe a second salvage treatment procedure of 4 patients.Material and methodsFour patients with a pathologically proven second local recurrence were treated in an outpatient magnetic resonance imaging (MRI)-guided setting with a single fraction of 19 Gy focal high-dose-rate brachytherapy (HDR-BT). Delineation was performed using choline-PET-CT or a 68Ga-PSMA PET in combination with multiparametric 3 Tesla MRI in all four patients. Toxicity was measured using common toxicity criteria for adverse events (CTCAE) version 4.0.ResultsWith a median follow-up of 12 months (range, 6-15), there were 2 patients with biochemical recurrence as defined by the Phoenix-definition. There were no patients with grade 3 or more toxicity. In all second salvage HDR-BT treatments, the constraints for rectum, bladder, and urethra were met. Median treatment volume (GTV) was 4.8 cc (range, 1.9-6.6 cc). A median of 8 catheters (range, 6-9) were used, and the median dose to the treatment volume (GTV) was a D95: 19.3 Gy (SD 15.5-19.4 Gy).ConclusionsSecond focal salvage MRI-guided HDR-BT for a select group of patients with a second locally recurrent prostate cancer is feasible. There was no grade 3 or more acute toxicity for these four patients.

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Rectal dose constraints for salvage iodine-125 prostate brachytherapy

Cited by 21 publications

References 34 publications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Prostate external beam radiotherapy combined with high-dose-rate brachytherapy: dose-volume parameters from deformably-registered plans correlate with late gastrointestinal complications

Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

Second salvage high-dose-rate brachytherapy for radiorecurrent prostate cancer

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