Treatment technique evolution and dosimetry trends over seven years of low dose rate prostate brachytherapy at an Australian institution

Rutten, Thomas P.; Lawson, John M.; Marcu, Loredana G.

doi:10.1016/j.ejmp.2012.07.004

Cited by 6 publications

(3 citation statements)

References 15 publications

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“…Some studies have shown that rectal dose decreases with the physician’s clinical experience [6] while others found no such effect. Certain groups [7] found that the dose to the rectum increased with prostate volume [8]. Recently, Patil et al [9] identified body mass index (BMI) as one of several factors that are negatively correlated with rectal dosimetry.…”

Section: Introductionmentioning

confidence: 99%

Influence of body mass index and periprostatic fat on rectal dosimetry in permanent seed prostate brachytherapy

et al. 2014

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PurposeWe examined the influence of body mass index (BMI) and body fat distribution on rectal dose in patients treated with permanent seed brachytherapy for localized prostate cancer.Methods and materialsWe analyzed 213 patients treated with I125 seed brachytherapy for localized prostate cancer. BMI and rectal dosimetry data for all patients were available. Data on visceral and subcutaneous fat distribution at the level of the iliac crest (n = 140) as well as the distribution of periprostatic and subcutaneous fat at the symphysis pubis level were obtained (n = 117). Fat distribution was manually contoured on CT on day 30 after brachytherapy. The correlation between BMI, fat distribution and rectal dose (R100 (in cc), R150 (cc), D2 (Gy)) was analyzed using the Spearman correlation coefficient. Differences in rectal dose between tertiles of body fat distribution were calculated using nonparametric tests.ResultsPeriprostatic adipose was only weakly correlated with BMI (r = 0.0.245, p = 0.008) and only weakly correlated with the other fat measurements (r = 0.31-0.37, p < 0.001). On the other hand, BMI was correlated with all other fat measurements (≥0.58, p < 0.001). All the other fat measurements were strongly correlated with each other (r = 0.5-0.87, p < 0.001). Patients with an R100 of >1.3 cc (23% of patients) had less visceral fat (p = 0.004), less subcutaneous fat at the level of the iliac crest (p = 0.046) and a lower BMI (26.8 kg/m2 vs. 28.5 kg/m2, p = 0.02) than patients with an R100 of <1.3 cc. Results were very similar when comparing an R100 of >1.0 cc (34% of patients) across the tertiles. None of the tested linear regression models were predictive (max 12%) of dose to the rectum.ConclusionDose to the rectum is dependent on BMI and body fat distribution. Periprostatic fat does not influence rectal dose. Dose to the rectum remains difficult to predict and depends on many factors, one of which is body fat distribution.

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Section: Introductionmentioning

confidence: 99%

Influence of body mass index and periprostatic fat on rectal dosimetry in permanent seed prostate brachytherapy

et al. 2014

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“…Both low-dose-rate (LDR) and high-dose-rate (HDR) treatment techniques are used as curative treatment, either as monotherapy or in combination with external beam irradiation [5]. LDR brachytherapy with permanently implanted I125 "seeds" is a widely used and well-proven method in the treatment of patients with low-risk or selected intermediate-risk, organ-confned prostate cancer [6][7][8][9][10]. Te original use of prostate HDRBT was as a boost dose to raise the dose given to the prostate amending the external beam therapy [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported Questionnaires

Gesztesi,

Kocsis,

Jorgo

et al. 2024

Prostate Cancer

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The aim of the study was to compare the side effects of high-dose-rate brachytherapy (HDRBT) and low-dose-rate brachytherapy (LDRBT), with a particular focus on the effects on sexual functions and sexual well-being (PROMOBRA study, NCT02258087). Localized low-risk and low-intermediate-risk prostate cancer patients were treated with mono LDR (N = 123, 145 Gy dose) or mono HDR brachytherapy (N = 117, 19/21 Gy). Prior to the treatment and during follow-up (at 3, 6, 9, 12, 18, and 24 months after treatment, and then annually after two years), patients completed patient-reported outcome measurement (PROM) questionnaires EORTC QLQ-PR-25, International Index of Erectile Function (IIEF), and IIEF-5 (SHIM). We compared the patients in different group breakdowns (HDR vs. LDR, hormone naïve and hormone-receiving HDR vs. LDR, hormone naïve and hormone-receiving patients in general, and 19 Gy HDR vs. 21 Gy HDR). In the hormone-naive LDR group, erectile function, orgasm function, sexual desire, satisfaction with intercourse, and overall satisfaction functions significantly decreased compared to baseline throughout the whole follow-up period. However, there were significant decreases in function at a maximum of three time points after HDR therapy without hormone therapy. In hormone-receiving patients, the orgasm function was significantly better in the HDR group at multiple time points compared to the baseline, and sexual desire improved at four time points. According to our results, both LDRBT and HDRBT can be safely administered to patients with localized prostate cancer. In hormone-naive patients, the HDR group showed only recovering decreases in sexual functions, while the LDR group showed a lasting decline in multiple areas. Thus, HDR appears to be more advantageous to hormone-naive patients.

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“…Prostate brachytherapy has a specific role for localized tumors. [1][2][3] High-dose-rate (HDR) prostate brachytherapy has been used increasingly over recent decades as fewer and larger fractions have been implemented 4 fueled by radiobiological data 5,6 In addition, HDR treatments provide better radiation protection, better professional shielding and potentially better dose distribution. Definitive prostate HDR has been used for escalating radiation doses in recent years 7 and some treatment schemes have proven to be a good brachytherapy option.…”

Section: Introductionmentioning

confidence: 99%

LDR brachytherapy offers superior tumor control to single‐fraction HDR prostate brachytherapy: A prospective study

Jimenez‐Garcia,

Sabater,

Martinez‐Gutierrez

et al. 2023

The Prostate

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Purpose To compare the clinical outcomes of single‐fraction high‐dose‐rate (HDR) brachytherapy and single‐fraction low‐dose‐rate (LDR) brachytherapy as the sole treatment for primary prostate cancer. Material and Methods A quasi‐randomized study that allocated, from March 2008 to February 2012, 129 low and intermediate risk prostate cancer patients to one single‐fraction HDR of 19 Gy (61 patients) or to a 145 Gy 125I LDR permanent implant (68 patients. Biochemical relapse‐free survival (bRFS) and overall survival (OS) were compared using the Kaplan–Meier method and Cox regression analysis. Results After a median follow‐up of 72 months in the HDR group, 26 patients relapsed, and after a median follow‐up of 84 months in the LDR group, 7 patients relapsed (p < 0.0001). The 5‐year bRFS was significantly better for the LDR group than for the HDR group (93.7% and 61.1%, respectively) (p < 0.0001). The 5‐year OS also was significantly better in the LDR group (95.5% vs. 89.9%) (p = 0.0436). Conclusions Permanent LDR prostate implant brachytherapy offers better clinical outcomes than single‐fraction HDR for prostate cancer.

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Treatment technique evolution and dosimetry trends over seven years of low dose rate prostate brachytherapy at an Australian institution

Cited by 6 publications

References 15 publications

Influence of body mass index and periprostatic fat on rectal dosimetry in permanent seed prostate brachytherapy

Influence of body mass index and periprostatic fat on rectal dosimetry in permanent seed prostate brachytherapy

Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported Questionnaires

LDR brachytherapy offers superior tumor control to single‐fraction HDR prostate brachytherapy: A prospective study

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