Dose Escalation to the Dominant Intraprostatic Lesion Defined by Sextant Biopsy in a Permanent Prostate I-125 Implant: A Prospective Comparative Toxicity Analysis

Journal Article · Sat May 01 00:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.04.049· OSTI ID:21372254

Gaudet, Marc; Vigneault, Eric; Aubin, Sylviane; Varfalvy, Nicolas ^[1]; Harel, Francois ^[2]; Beaulieu, L ^[1]; Martin, Andre-Guy ^[1]

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1. Departement de radio-oncologie, L'Hotel-Dieu de Quebec (Canada)
2. Centre de recherche de l'Hotel-Dieu de Quebec, L'Hotel-Dieu de Quebec (Canada)

Purpose: Using real-time intraoperative inverse-planned permanent seed prostate implant (RTIOP/PSI), multiple core biopsy maps, and three-dimensional ultrasound guidance, we planned a boost volume (BV) within the prostate to which hyperdosage was delivered selectively. The aim of this study was to investigate the potential negative effects of such a procedure. Methods and Materials: Patients treated with RTIOP/PSI for localized prostate cancer with topographic biopsy results received an intraprostatic boost (boost group [BG]). They were compared with patients treated with a standard plan (reference group [RG]). Plans were generated using a simulated annealing inverse planning algorithm. Prospectively recorded urinary, rectal, and sexual toxicities and dosimetric parameters were compared between groups. Results: The study included 120 patients treated with boost technique who were compared with 70 patients treated with a standard plan. Boost technique did not significantly change the number of seeds (55.1/RG vs. 53.6/BG). The intraoperative prostate V150 was slightly higher in BG (75.2/RG vs. 77.2/BG, p = 0.039). Urethra V100, urethra D90, and rectal D50 were significantly lower in the BG. No significant differences were seen in acute or late urinary, rectal, or sexual toxicities. Conclusions: Because there were no differences between the groups in acute and late toxicities, we believe that BV can be planned and delivered to the dominant intraprostatic lesion without increasing toxicity. It is too soon to say whether a boost technique will ultimately increase local control.

• OSTI ID: 21372254
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 77, Issue 1; Other Information: DOI: 10.1016/j.ijrobp.2009.04.049; PII: S0360-3016(09)00647-6; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOPSY
BRACHYTHERAPY
IODINE 125
NEOPLASMS
PLANNING
PROSTATE
RADIATION DOSES
RADIATION SOURCE IMPLANTS
RECTUM
TOXICITY
URINARY TRACT
BETA DECAY RADIOISOTOPES
BODY
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DOSES
ELECTRON CAPTURE RADIOISOTOPES
GASTROINTESTINAL TRACT
GLANDS
IMPLANTS
INTERMEDIATE MASS NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
INTESTINES
IODINE ISOTOPES
ISOTOPES
LARGE INTESTINE
MALE GENITALS
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
THERAPY