Sector analysis provides additional spatial information on the permanent prostate brachytherapy learning curve

Yoosuf, Ahamed Badusha Mohamed; Mitchell, D.; Workman, G.; Jonnada, Sai; Napier, Eoin; Jain, Suneil

doi:10.1016/j.brachy.2015.05.009

Cited by 2 publications

(2 citation statements)

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“…CT scans were then transferred to the TPS and the structures including prostate, bladder and rectum were delineated. Although a pre-implantation plan is created to ensure 100% dose to the planning target volume, the practicalities of inserting needles into the prostate together with post-surgical oedema and seed migration can result in differences between the intended and delivered dose [23–25]. With this information, a dose distribution for each organ can be created for each patient; Fig.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, sector analysis of 12 prostatic regions (sectors) was conducted. As described in more details in previous publications [25, 26], sector analysis involved dividing the prostate into three equal lengths along the cranio-caudal axis to create base, mid-gland and apex, then sub-dividing with a vertical plane and a horizontal plane creating right/left anterior and right/ left posterior sectors (also see Additional file 1: Figure S1). D 90% was then determined for each sector of the prostate.…”

Section: Methodsmentioning

confidence: 99%

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Prostate cancer treated with brachytherapy; an exploratory study of dose-dependent biomarkers and quality of life

et al. 2017

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BackgroundLow-dose-rate permanent prostate brachytherapy (PPB) is an attractive treatment option for patients with localised prostate cancer with excellent outcomes. As standard CT-based post-implant dosimetry often correlates poorly with late treatment-related toxicity, this exploratory (proof of concept) study was conducted to investigate correlations between radiation − induced DNA damage biomarker levels, and acute and late bowel, urinary, and sexual toxicity.MethodsTwelve patients treated with 125I PPB monotherapy (145Gy) for prostate cancer were included in this prospective study. Post-implant CT based dosimetry assessed the minimum dose encompassing 90% (D90%) of the whole prostate volume (global), sub-regions of the prostate (12 sectors) and the near maximum doses (D0.1cc, D2cc) for the rectum and bladder. Six blood samples were collected from each patient; pre-treatment, 1 h (h), 4 h, 24 h post-implant, at 4 weeks (w) and at 3 months (m). DNA double strand breaks were investigated by staining the blood samples with immunofluorescence antibodies to γH2AX and 53BP1 proteins (γH2AX/53BP1). Patient self-scored quality of life from the Expanded Prostate Cancer Index Composite (EPIC) were obtained at baseline, 1 m, 3 m, 6 m, 9 m, 1 year (y), 2y and 3y post-treatment. Spearman’s correlation coefficients were used to evaluate correlations between temporal changes in γH2AX/53BP1, dose and toxicity.ResultsThe minimum follow up was 2 years. Population mean prostate D90% was 144.6 ± 12.1 Gy and rectal near maximum dose D0.1cc = 153.0 ± 30.8 Gy and D2cc = 62.7 ± 12.1 Gy and for the bladder D0.1cc = 123.1 ± 27.0 Gy and D2cc = 70.9 ± 11.9 Gy. Changes in EPIC scores from baseline showed high positive correlation between acute toxicity and late toxicity for both urinary and bowel symptoms. Increased production of γH2AX/53BP1 at 24 h relative to baseline positively correlated with late bowel symptoms. Overall, no correlations were observed between dose metrics (prostate global or sector doses) and γH2AX/53BP1 foci counts.ConclusionsOur results show that a prompt increase in γH2AX/53BP1foci at 24 h post-implant relative to baseline may be a useful measure to assess elevated risk of late RT − related toxicities for PPB patients. A subsequent investigation recruiting a larger cohort of patients is warranted to verify our findings.Electronic supplementary materialThe online version of this article (doi:10.1186/s13014-017-0792-1) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%