Results of high dose-rate brachytherapy boost before 2D or 3D external beam irradiation for prostate cancer

Neviani, Cristiano Beck; Miziara, Miguel; Carvalho, Heloísa de Andrade

doi:10.1016/j.radonc.2011.01.005

Cited by 18 publications

(5 citation statements)

References 39 publications

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“…The supplemental EBRT doses range from 45 to 54 Gy (normofractionation), generating total BED 1.5 and EQD2 doses in the range of 171–366 Gy and 74–137 Gy, respectively. 9 , 10 , 14 , 15 , 16 , 56 , 59 , 68 , 69 , 79 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 The reported severe late GU and GI adverse events rates compare favorably with late toxicity rates in dose‐escalated EBRT series. 71 , 105 , 106 , 108 It must be noted that hypofractionated EBRT protocols are gaining momentum, 94 , 95 appearing equieffective in regard to clinical outcome, while demonstrating favorable toxicity profile.…”

Section: Clinical Datamentioning

confidence: 99%

High‐dose‐rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome

et al. 2021

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Background: High-dose-rate brachytherapy (HDR BRT) has been enjoying rapid acceptance as a treatment modality offered to selected prostate cancer patients devoid of risk group, employed either in monotherapy setting or combined with external beam radiation therapy (EBRT) and is currently one of the most active clinical research areas.Recent findings: This review encompasses all the current evidence to support the use of HDR BRT in various clinical scenario and shines light to the HDR BRT rationale, as an ultimately conformal dose delivery method enabling safe dose escalation to the prostate. Conclusion:Valid long-term data, both in regard to the oncologic outcomes and toxicity profile, support the current clinical indication spectrum of HDR BRT. At the same time, this serves as solid, rigid ground for emerging therapeutic applications, allowing the technique to remain in the spotlight alongside stereotactic radiosurgery.

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Section: Clinical Datamentioning

confidence: 99%

High‐dose‐rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome

et al. 2021

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“…Interstitial High dose rate (HDR) brachytherapy for the treatment of prostate cancer is an effective therapy delivered either as monotherapy or as a boost in combination with external beam radiotherapy (EBRT) (Zwahlen et al 2010, Ágoston et al 2011, Neviani et al 2011, Aluwini et al 2012, Hoskin et al 2012, Kaprealian et al 2012, Wojcieszek and Białas 2012, Morton 2014, Spratt et al 2014, Chin et al 2017, Mendez & Morton 2018, Morton and Alrashidi 2020. A recent randomized trial of EBRT conducted alone and combined penalty weights on the Pareto surface between DVH objectives in HDR brachytherapy treatment planning.…”

Section: Introduction 1high Dose Rate Brachytherapymentioning

confidence: 99%

Penalty weight tuning in high dose rate brachytherapy using multi-objective Bayesian optimization

Jafarzadeh,

Antaki,

Mao

et al. 2024

Phys. Med. Biol.

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Objective: Treatment plan optimization in high dose rate (HDR) brachytherapy often requires manual fine-tuning of penalty weights for each objective, which can be time-consuming and dependent on the planner’s experience. To automate this process, this study used a multi-criteria approach called multi-objective Bayesian optimization with q-noisy expected hypervolume improvement as its acquisition function (MOBO-qNEHVI).Approach: The treatment plans of 13 prostate cancer patients were retrospectively imported to a research treatment planning system, RapidBrachyMTPS, where fast mixed integer optimization (FMIO) performs dwell time optimization given a set of penalty weights to deliver 15 Gy to the target volume. MOBO-qNEHVI was used to find patient-specific Pareto optimal penalty weight vectors that yield clinically acceptable dose volume histogram metrics. The relationship between the number of MOBO-qNEHVI iterations and the number of clinically acceptable plans per patient (acceptance rate) was investigated. The performance time was obtained for various parameter configurations.Main results: MOBO-qNEHVI found clinically acceptable treatment plans for all patients. With increasing the number of MOBO-qNEHVI iterations, the acceptance rate grew logarithmically while the performance time grew exponentially. Fixing the penalty weight of the tumour volume to maximum value, adding the target dose as a parameter, initiating MOBO-qNEHVI with 25 parallel sampling of FMIO, and running 6 MOBO-qNEHVI iterations found solutions that delivered 15 Gy to the hottest 95% of the clinical target volume while respecting the dose constraints to the organs at risk. The average acceptance rate for each patient was 89.74% ± 8.11%, and performance time was 66.6 ± 12.6 seconds. The initiation took 22.47 ± 7.57 s, and each iteration took 7.35 ± 2.45 s to find one Pareto solution.Significance: MOBO-qNEHVI can automatically explore the trade-offs between treatment plan objectives in a patient-specific manner within a minute. This approach can reduce the dependency of plan quality on planner's experience.

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“…Up to date, no standard treatment regime of combined EBRT and HDR-BT boost exists and the GEC/ESTRO guidelines state a wide range of possible regimes mostly based on published retrospective trials (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). While randomized trial data on this subject remains scarce, there is limited data on two-weekly HDR-BT boost after EBRT (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Two-Weekly High-Dose-Rate Brachytherapy Boost After External Beam Radiotherapy for Localized Prostate Cancer: Long-Term Outcome and Toxicity Analysis

et al. 2021

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PurposeEvaluation of clinical outcome of two-weekly high-dose-rate brachytherapy boost after external beam radiotherapy (EBRT) for localized prostate cancer.Methods338 patients with localized prostate cancer receiving definitive EBRT followed by a two-weekly high-dose-rate brachytherapy boost (HDR-BT boost) in the period of 2002 to 2019 were analyzed. EBRT, delivered in 46 Gy (DMean) in conventional fractionation, was followed by two fractions HDR-BT boost with 9 Gy (D90%) two and four weeks after EBRT. Androgen deprivation therapy (ADT) was added in 176 (52.1%) patients. Genitourinary (GU)/gastrointestinal (GI) toxicity was evaluated utilizing the Common Toxicity Criteria for Adverse Events (version 5.0) and biochemical failure was defined according to the Phoenix definition.ResultsMedian follow-up was 101.8 months. 15 (4.4%)/115 (34.0%)/208 (61.5%) patients had low-/intermediate-/high-risk cancer according to the D`Amico risk classification. Estimated 5-year and 10-year biochemical relapse-free survival (bRFS) was 84.7% and 75.9% for all patients. The estimated 5-year bRFS was 93.3%, 93.4% and 79.5% for low-, intermediate- and high-risk disease, respectively. The estimated 10-year freedom from distant metastasis (FFM) and overall survival (OS) rates were 86.5% and 70.0%. Cumulative 5-year late GU toxicity and late GI toxicity grade ≥ 2 was observed in 19.3% and 5.0% of the patients, respectively. Cumulative 5-year late grade 3 GU/GI toxicity occurred in 3.6%/0.3%.ConclusionsTwo-weekly HDR-BT boost after EBRT for localized prostate cancer showed an excellent toxicity profile with low GU/GI toxicity rates and effective long-term biochemical control.

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Results of high dose-rate brachytherapy boost before 2D or 3D external beam irradiation for prostate cancer

Cited by 18 publications

References 39 publications

High‐dose‐rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome

High‐dose‐rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome

Penalty weight tuning in high dose rate brachytherapy using multi-objective Bayesian optimization

Two-Weekly High-Dose-Rate Brachytherapy Boost After External Beam Radiotherapy for Localized Prostate Cancer: Long-Term Outcome and Toxicity Analysis

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