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Title: Bypassing the learning curve in permanent seed implants using state-of-the-art technology

Abstract

Purpose: The aim of this study was to demonstrate, based on clinical postplan dose distributions, that technology can be used efficiently to eliminate the learning curve associated with permanent seed implant planning and delivery. Methods and Materials: Dose distributions evaluated 30 days after the implant of the initial 22 consecutive patients treated with permanent seed implants at two institutions were studied. Institution 1 (I1) consisted of a new team, whereas institution 2 (I2) had performed more than 740 preplanned implantations over a 9-year period before the study. Both teams had adopted similar integrated systems based on three-dimensional (3D) transrectal ultrasonography, intraoperative dosimetry, and an automated seed delivery and needle retraction system (FIRST, Nucletron). Procedure time and dose volume histogram parameters such as D90, V100, V150, V200, and others were collected in the operating room and at 30 days postplan. Results: The average target coverage from the intraoperative plan (V100) was 99.4% for I1 and 99.9% for I2. D90, V150, and V200 were 191.4 Gy (196.3 Gy), 75.3% (73.0%), and 37.5% (34.1%) for I1 (I2) respectively. None of these parameters shows a significant difference between institutions. The postplan D90 was 151.2 Gy for I1 and 167.3 Gy for I2, well abovemore » the 140 Gy from the Stock et al. analysis, taking into account differences at planning, results in a p value of 0.0676. The procedure time required on average 174.4 min for I1 and 89 min for I2. The time was found to decrease with the increasing number of patients. Conclusion: State-of-the-art technology enables a new brachytherapy team to obtain excellent postplan dose distributions, similar to those achieved by an experienced team with proven long-term clinical results. The cost for bypassing the usual dosimetry learning curve is time, with increasing team experience resulting in shorter treatment times.« less

Authors:
 [1];  [2];  [3];  [2];  [2];  [2];  [3];  [3];  [3];  [2]
  1. Departement de Radio-oncologie, Centre Hospitalier Universitaire de Quebec, Hotel-Dieu de Quebec, Quebec, PQ (Canada). E-mail: beaulieu@phy.ulaval.ca
  2. Departments of Radiation Oncology and Medical Physics, Tom Baker Cancer Centre, Calgary, AB (Canada)
  3. Departement de Radio-oncologie, Centre Hospitalier Universitaire de Quebec, Hotel-Dieu de Quebec, Quebec, PQ (Canada)
Publication Date:
OSTI Identifier:
20850296
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2006.07.019; PII: S0360-3016(06)01256-9; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; DOSIMETRY; LEARNING; OPTIMIZATION; PATIENTS; PLANNING; PROSTATE; RADIATION DOSE DISTRIBUTIONS; RADIATION DOSES; RADIATION SOURCE IMPLANTS; ULTRASONOGRAPHY

Citation Formats

Beaulieu, Luc, Evans, Dee-Ann Radford, Aubin, Sylviane, Angyalfi, Steven, Husain, Siraj, Kay, Ian, Martin, Andre-Guy, Varfalvy, Nicolas, Vigneault, Eric, and Dunscombe, Peter. Bypassing the learning curve in permanent seed implants using state-of-the-art technology. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.07.019.
Beaulieu, Luc, Evans, Dee-Ann Radford, Aubin, Sylviane, Angyalfi, Steven, Husain, Siraj, Kay, Ian, Martin, Andre-Guy, Varfalvy, Nicolas, Vigneault, Eric, & Dunscombe, Peter. Bypassing the learning curve in permanent seed implants using state-of-the-art technology. United States. doi:10.1016/j.ijrobp.2006.07.019.
Beaulieu, Luc, Evans, Dee-Ann Radford, Aubin, Sylviane, Angyalfi, Steven, Husain, Siraj, Kay, Ian, Martin, Andre-Guy, Varfalvy, Nicolas, Vigneault, Eric, and Dunscombe, Peter. Mon . "Bypassing the learning curve in permanent seed implants using state-of-the-art technology". United States. doi:10.1016/j.ijrobp.2006.07.019.
@article{osti_20850296,
title = {Bypassing the learning curve in permanent seed implants using state-of-the-art technology},
author = {Beaulieu, Luc and Evans, Dee-Ann Radford and Aubin, Sylviane and Angyalfi, Steven and Husain, Siraj and Kay, Ian and Martin, Andre-Guy and Varfalvy, Nicolas and Vigneault, Eric and Dunscombe, Peter},
abstractNote = {Purpose: The aim of this study was to demonstrate, based on clinical postplan dose distributions, that technology can be used efficiently to eliminate the learning curve associated with permanent seed implant planning and delivery. Methods and Materials: Dose distributions evaluated 30 days after the implant of the initial 22 consecutive patients treated with permanent seed implants at two institutions were studied. Institution 1 (I1) consisted of a new team, whereas institution 2 (I2) had performed more than 740 preplanned implantations over a 9-year period before the study. Both teams had adopted similar integrated systems based on three-dimensional (3D) transrectal ultrasonography, intraoperative dosimetry, and an automated seed delivery and needle retraction system (FIRST, Nucletron). Procedure time and dose volume histogram parameters such as D90, V100, V150, V200, and others were collected in the operating room and at 30 days postplan. Results: The average target coverage from the intraoperative plan (V100) was 99.4% for I1 and 99.9% for I2. D90, V150, and V200 were 191.4 Gy (196.3 Gy), 75.3% (73.0%), and 37.5% (34.1%) for I1 (I2) respectively. None of these parameters shows a significant difference between institutions. The postplan D90 was 151.2 Gy for I1 and 167.3 Gy for I2, well above the 140 Gy from the Stock et al. analysis, taking into account differences at planning, results in a p value of 0.0676. The procedure time required on average 174.4 min for I1 and 89 min for I2. The time was found to decrease with the increasing number of patients. Conclusion: State-of-the-art technology enables a new brachytherapy team to obtain excellent postplan dose distributions, similar to those achieved by an experienced team with proven long-term clinical results. The cost for bypassing the usual dosimetry learning curve is time, with increasing team experience resulting in shorter treatment times.},
doi = {10.1016/j.ijrobp.2006.07.019},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 67,
place = {United States},
year = {Mon Jan 01 00:00:00 EST 2007},
month = {Mon Jan 01 00:00:00 EST 2007}
}