Your browser doesn't support javascript.
loading
Permanent LDR prostate brachytherapy: Comprehensive characterization of seed-dynamics within the prostate on a seed-only level.
Karius, Andre; Lotter, Michael; Kreppner, Stephan; Schaller, Verena; Lubgan, Dorota; Grigo, Johanna; Fietkau, Rainer; Strnad, Vratislav; Bert, Christoph.
Afiliação
  • Karius A; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany. Electronic address: andre.karius@uk-erlangen.de.
  • Lotter M; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Kreppner S; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Schaller V; Faculty of Medicine, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany.
  • Lubgan D; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Grigo J; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Fietkau R; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Strnad V; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
  • Bert C; Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Bavaria, Germany.
Brachytherapy ; 21(5): 635-646, 2022.
Article em En | MEDLINE | ID: mdl-35643593
PURPOSE: Seed brachytherapy is a well-established treatment modality for prostate cancer. However, there is still a lack of profound characterizations of seed motions within the prostate. We assessed these dynamics between day 0 and day 30 of brachytherapy. METHODS: We considered 45 patients with 2408 implanted seeds, and performed a 1:1 assignment between their positions on post-plan CT (nominal day 30) and intraoperative ultrasound (day 0). Geometric seed arrangement changes were measured for each patient and the entire collective. The impact of seed strand-lengths and implant regions was investigated. Correlations with patient characteristics were evaluated. We determined corresponding dosimetric effects by calculating common dose metrics. RESULTS: We found a median seed displacement of 4.3 mm [interquartile range: 3.1-6.9 mm], occurring preferentially in superior-inferior direction. Single and double strands moved significantly stronger than strands of higher lengths. Seed dynamics was more pronounced in base (5.6 mm [3.7-10.7 mm]) and apex (6.5 mm [4.1-15.0 mm]) than in the mid-gland (3.8 mm [2.7-5.0 mm]), and less pronounced in peripheral (4.3 mm [3.0-6.7 mm]) than in urethra-near (5.5 mm [3.5-10.7 mm]) regions. Correlations of seed dynamics with prostate volume changes and the number of implanted seeds and needles were found. D90 (dose that 90% of the prostate receives) varied by a median of 3 Gy [-6 to 15 Gy] between treatment plan and post-plan, but >40 Gy for individual patients. CONCLUSIONS: Reducing seed dynamics is important to ensure a high treatment quality. For this, strands containing ≥3 seeds may be useful, implantations in base-, apex-, and urethra-near zone should be avoided, and the number of needles and seeds may be minimized where possible.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia Limite: Humans / Male Idioma: En Revista: Brachytherapy Assunto da revista: RADIOTERAPIA Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Braquiterapia Limite: Humans / Male Idioma: En Revista: Brachytherapy Assunto da revista: RADIOTERAPIA Ano de publicação: 2022 Tipo de documento: Article