| Dosimetric effect of external beam planning preceding combined high-dose-rate brachytherapy of the prostate. | |
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MedLine Citation:
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PMID: 21111686 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: The sequencing of external beam radiotherapy (EBRT) and a high-dose-rate brachytherapy (HDRB) boost is often interchangeable in clinical practice. When given before EBRT, HDRB could induce volume alterations in the prostate, which may have significant implications for EBRT dosimetry. We aimed to assess the influence of HDRB on prostate volume and, hence, prostate dosing via subsequent EBRT. METHODS AND MATERIALS: Fifteen men had both pre- and post-HDRB CT performed followed by EBRT. After deidentification, the clinical target volume (CTV) was defined on each CT by a single-blinded observer. Volumes were compared for the pre- and post-HDRB scans in each patient. Radiotherapy planning was performed using the prebrachytherapy volumes aiming for the planning target volume (PTV) to be covered by 43.7Gy. After soft-tissue coregistration, this plan was also applied to the postbrachytherapy volumes. RESULTS: Median volume increase was 35.4% for the CTV after HDRB. No patient experienced a decrease in CTV volume (range, 0-79% volume increase; p-value<0.001). Median volume increase was 26.1% for the PTVs, with no volume decrease observed (range, 8-56%; p<0.001). PTV proportion achieving dose target (V43.7Gy) decreased by median of 7% (range, 0-21.5%; p=0.004). The minimum dose to the PTV (D(100)%) decreased by a median of 6Gy (range, 0.5-16Gy; p<0.001). CONCLUSIONS: Insertion of HDRB catheters exerts substantial acute volumetric distortion on the prostate. EBRT planning performed on the basis of pre-HDRB imaging only inherently risks underdosing tumor. Planning adjustments based on repeat CT, or dedicated post-HDBT planning, is warranted for men managed with HDRB before EBRT. |
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Authors:
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Jarad M Martin; Richard Brett; Jemma Blyth; Stewart Morrison; Daniel Bryant; Ashley Plank; Robyn Cheuk; Michael Fay; Graeme Dickie; John Yaxley |
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Publication Detail:
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Type: Journal Article Date: 2010-11-26 |
Journal Detail:
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Title: Brachytherapy Volume: 10 ISSN: 1873-1449 ISO Abbreviation: Brachytherapy Publication Date: 2011 Nov-Dec |
Date Detail:
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Created Date: 2011-11-04 Completed Date: 2012-02-21 Revised Date: 2012-02-27 |
Medline Journal Info:
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Nlm Unique ID: 101137600 Medline TA: Brachytherapy Country: United States |
Other Details:
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Languages: eng Pagination: 474-8 Citation Subset: IM |
Copyright Information:
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Copyright © 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Oncology, Cancer Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. jarad.martin@roq.net.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Male Organ Size Prostate / pathology* Prostatic Neoplasms / radiotherapy* Radiotherapy / methods Radiotherapy Dosage Radiotherapy Planning, Computer-Assisted* / methods Radiotherapy, Conformal |
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