PO-1020: Permanent seed brachytherapy for low-risk prostate cancer: Long-term outcomes at the Catalan Institute of Oncology
Cristina Gutiérrez MiguélezAntonino DaidoneE. Martínez PérezJ. PeraF. Ferrer GonzálezA.M. Boladeras IngladaS. Botella GonzálezF. Pino SorrocheF. Suárez NovoF. Guedea Edo
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Objective To assess the brachytherapy effectiveness and the utilization of 103 Pd seeds in tumor therapy. Methods 31 103 Pd seed brachytherapy patients were studied in RTOG/EORTC acute and late radiation morbidity scoring criteria. Results The brachytherapy effect of 103 Pd seeds in tumor patients is obvious.28 of 31 patients showed 0 score in acute criteria. 2 of 31 patients died without the brachytherapy reason. The late scoring is still needed. Conclusions The 103 Pd seeds can be safely used in brachytherapy of tumors which are low or midiam sensitive to radiotherapy.
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Men presenting with clinically confined prostate cancer have a variety of established treatment options, among them brachytherapy is gaining increased acceptance, even in the absence of randomized comparative data between brachytherapy, surgery and external radiotherapy. This review summarizes the results of low dose rate transrectal-guided transperineal permanent seed implantation brachytherapy. We present the evolution of the different treatment planning techniques and a comprehensive review of published mature data on 10-year or longer of biochemical and survival outcome for brachytherapy alone, and brachytherapy combined with supplemental external beam radiation therapy with emphasis on its impact on quality of life.
External beam radiation
Prostate brachytherapy
External beam radiotherapy
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Brachytherapy has evolved over many decades, but more recently, there have been significant changes in the way that brachytherapy is used for different treatment sites. This has been due to the development of new, technologically advanced computer planning systems and treatment delivery techniques. Modern, three-dimensional (3D) imaging modalities have been incorporated into treatment planning methods, allowing full 3D dose distributions to be computed. Treatment techniques involving online planning have emerged, allowing dose distributions to be calculated and updated in real time based on the actual clinical situation. In the case of early stage breast cancer treatment, for example, electronic brachytherapy treatment techniques are being used in which the radiation dose is delivered during the same procedure as the surgery. There have also been significant advances in treatment applicator design, which allow the use of modern 3D imaging techniques for planning, and manufacturers have begun to implement new dose calculation algorithms that will correct for applicator shielding and tissue inhomogeneities. This article aims to review the recent developments and best practice in brachytherapy techniques and treatments. It will look at how imaging developments have been incorporated into current brachytherapy treatment and how these developments have played an integral role in the modern brachytherapy era. The planning requirements for different treatments sites are reviewed as well as the future developments of brachytherapy in radiobiology and treatment planning dose calculation.
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BACKGROUND An increase in the proportion of prostate carcinomas diagnosed at early, potentially curable stages has led to several changes in treatment of patients with this disease. Greater use of radical prostatectomy and external beam radiation has been documented, and recent data suggest that the use of radiation implant (brachytherapy) also has increased. Recent results from the National Cancer Data Base (NCDB) are available to explore this trend in greater detail. METHODS Data provided by 1758 hospital cancer registries for 435,264 patients diagnosed between 1992 and 1996 were studied. Reported use of brachytherapy was analyzed by year of diagnosis, region, patient age at diagnosis, and tumor grade. RESULTS The proportion of all prostate carcinoma patients treated with brachytherapy increased from 1.4% in 1992 to 3.0% in 1995. Ninety-six percent of brachytherapy patients were American Joint Committee on Cancer Stage I or II (with tumors classified as T1 or T2). As a proportion of patients in a stage group, the use of brachytherapy was greatest in Stage I; 3.7% of patients in this stage were treated by this modality. The increase in brachytherapy also was greatest among Stage I patients, rising from 2.0% in 1992 to 5.8% in 1996. Rates of use were greatest in the northeastern and southeastern U.S. and least frequently reported by institutions in the Midwest and the South. Brachytherapy was used across a wide range of patient age groups. Analysis by grade showed that 89.8% of patients treated with brachytherapy had well-differentiated or moderately differentiated tumors. CONCLUSIONS Brachytherapy represented a small component of the overall pattern of care for prostate carcinoma patients in the U.S. during the interval studied. However, the rate of use of this modality for patients with localized prostate carcinoma increased substantially over the 5-year interval. This may reflect a trend toward more conservative management of prostate carcinoma. Additional monitoring and analysis of the more recent use of brachytherapy for the treatment of prostate carcinoma patients is warranted. [See editorial on pages 1632–4, this issue.] Cancer 1999;86:1877–82. © 1999 American Cancer Society.
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Brachytherapy has been a popular topic for AAPM summer schools, with this marking the third time the subject has been covered (past schools on the topic were held in 1994 and 2005). This book was developed for the AAPM 2017 Summer School in Portland, Oregon, held in conjunction with the American Brachytherapy Association. From Joann Prisciandaro in Medical Physics… "Overall, this text is well written and provides a nice summary of current and developing clinical brachytherapy practice patterns. …from my perspective as a practicing brachytherapy physicist and educator, this text will make an extremely useful reference and will certainly be added to my list of required reading for residents and graduate students." This book is more than a comprehensive overview of the brachytherapy tools and techniques used in a modern clinic. The book also looks at numerous exciting approaches currently under development. Topics include HDR and LDR brachytherapy for the prostate, general planning and model-based dose calculation algorithms, intensity-modulated brachytherapy, electronic brachytherapy sources and techniques, and brachytherapy advances for treating skin, gynecological, and breast cancer. Some of the promising new techniques covered include focal therapy, the use of 3D printing to augment treatment, advances in needle tracking, in vivo dosimetry, and the use of robotics in brachytherapy.
Prostate brachytherapy
Physics Education
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Salvage therapy
Prostate brachytherapy
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