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Title: Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results

Abstract

Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3more » urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes.« less

Authors:
 [1]; ;  [1];  [2]; ; ; ;  [3]; ; ; ;  [1]
  1. Radiation Oncology Department, Institut Claudius Regaud, Toulouse (France)
  2. Department of Urology, Clinique Ambroise Paré, Toulouse (France)
  3. Department of Urology and Andrology, CHU Rangueil, Toulouse (France)
Publication Date:
OSTI Identifier:
22267931
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 87; Journal Issue: 4; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; IODINE 125; IRRADIATION CAPSULES; MULTIVARIATE ANALYSIS; NEOPLASMS; PROSTATE; RADIATION SOURCE IMPLANTS

Citation Formats

Genebes, Caroline, Filleron, Thomas, Graff, Pierre, Jonca, Frédéric, Huyghe, Eric, Thoulouzan, Matthieu, Soulie, Michel, Malavaud, Bernard, Aziza, Richard, Brun, Thomas, Delannes, Martine, and Bachaud, Jean-Marc. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results. United States: N. p., 2013. Web. doi:10.1016/J.IJROBP.2013.08.010.
Genebes, Caroline, Filleron, Thomas, Graff, Pierre, Jonca, Frédéric, Huyghe, Eric, Thoulouzan, Matthieu, Soulie, Michel, Malavaud, Bernard, Aziza, Richard, Brun, Thomas, Delannes, Martine, & Bachaud, Jean-Marc. Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results. United States. https://doi.org/10.1016/J.IJROBP.2013.08.010
Genebes, Caroline, Filleron, Thomas, Graff, Pierre, Jonca, Frédéric, Huyghe, Eric, Thoulouzan, Matthieu, Soulie, Michel, Malavaud, Bernard, Aziza, Richard, Brun, Thomas, Delannes, Martine, and Bachaud, Jean-Marc. 2013. "Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results". United States. https://doi.org/10.1016/J.IJROBP.2013.08.010.
@article{osti_22267931,
title = {Conventional Versus Automated Implantation of Loose Seeds in Prostate Brachytherapy: Analysis of Dosimetric and Clinical Results},
author = {Genebes, Caroline and Filleron, Thomas and Graff, Pierre and Jonca, Frédéric and Huyghe, Eric and Thoulouzan, Matthieu and Soulie, Michel and Malavaud, Bernard and Aziza, Richard and Brun, Thomas and Delannes, Martine and Bachaud, Jean-Marc},
abstractNote = {Purpose: To review the clinical outcome of I-125 permanent prostate brachytherapy (PPB) for low-risk and intermediate-risk prostate cancer and to compare 2 techniques of loose-seed implantation. Methods and Materials: 574 consecutive patients underwent I-125 PPB for low-risk and intermediate-risk prostate cancer between 2000 and 2008. Two successive techniques were used: conventional implantation from 2000 to 2004 and automated implantation (Nucletron, FIRST system) from 2004 to 2008. Dosimetric and biochemical recurrence-free (bNED) survival results were reported and compared for the 2 techniques. Univariate and multivariate analysis researched independent predictors for bNED survival. Results: 419 (73%) and 155 (27%) patients with low-risk and intermediate-risk disease, respectively, were treated (median follow-up time, 69.3 months). The 60-month bNED survival rates were 95.2% and 85.7%, respectively, for patients with low-risk and intermediate-risk disease (P=.04). In univariate analysis, patients treated with automated implantation had worse bNED survival rates than did those treated with conventional implantation (P<.0001). By day 30, patients treated with automated implantation showed lower values of dose delivered to 90% of prostate volume (D90) and volume of prostate receiving 100% of prescribed dose (V100). In multivariate analysis, implantation technique, Gleason score, and V100 on day 30 were independent predictors of recurrence-free status. Grade 3 urethritis and urinary incontinence were observed in 2.6% and 1.6% of the cohort, respectively, with no significant differences between the 2 techniques. No grade 3 proctitis was observed. Conclusion: Satisfactory 60-month bNED survival rates (93.1%) and acceptable toxicity (grade 3 urethritis <3%) were achieved by loose-seed implantation. Automated implantation was associated with worse dosimetric and bNED survival outcomes.},
doi = {10.1016/J.IJROBP.2013.08.010},
url = {https://www.osti.gov/biblio/22267931}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 87,
place = {United States},
year = {Fri Nov 15 00:00:00 EST 2013},
month = {Fri Nov 15 00:00:00 EST 2013}
}