Document Detail

Impact of learning curve and technical changes on dosimetry in low-dose brachytherapy for prostate cancer.
MedLine Citation:
PMID:  23142920     Owner:  NLM     Status:  Publisher    
PURPOSE: To assess the impact of experience and technical changes on peri- and postimplantation (1 month later) dosimetry for permanent prostate brachytherapy (PPB). PATIENTS AND METHODS: From July 2003 to May 2010, 150 prostate cancer patients underwent low-dose, loose-seed I(125) PPB as monotherapy with intraoperative planning. Patients were divided into three groups-P1 (n = 64), P2 (n = 45), P3 (n = 41)-according to the technical changes that occurred during the study period: use of an automatic stepper at the beginning of P2 and a high-frequency ultrasound probe in P3. Peri- and postimplantation dosimetric parameters (on day 30) were reported: D90 (dose received by 90% of prostate volume), V100 and V150 (prostate volume receiving, respectively, 100% and 150% of the prescribed dose), D2 cc and D0.1 cc (doses received by 2 cc and 0.1 cc of the rectum), R100 (rectum volume that received 100% of the prescribed dose), and D10 and D30 (doses received by 10% and 30% of the urethra, only during peri-implantation). RESULTS: We observed a decrease in the number of needles and seeds used over time. The mean peri-implantation D90 was 187.52 Gy without a significant difference between the three periods (p = 0.48). The postimplantation D90, V100, and V150 parameters were, respectively, 168.3 Gy, 91.9%, and 55% with no significant difference between the three periods. The peri-implantation and postimplantation D0.1 cc and R100 significantly decreased over time; on day 30: D0.1 cc P1 = 223.1 Gy vs. D0.1 cc P3 = 190.4 Gy (p = 8.10(- 5)) and R100 P1 = 1.06 cc vs. R100 P3 = 0.53 cc (p = 0.0008). CONCLUSION: We observed a learning curve for the implantation parameters, which led to a significant decrease in the rectal doses without having any impact on the prostate dosimetric parameters.
E Le Fur; J P Malhaire; D Baverez; F Delage; M A Perrouin-Verbe; F Schlurmann; S Guerif; G Fournier; O Pradier; A Valeri
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-11
Journal Detail:
Title:  Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]     Volume:  -     ISSN:  1439-099X     ISO Abbreviation:  Strahlenther Onkol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8603469     Medline TA:  Strahlenther Onkol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Radiation Therapy Department, CHU Brest, 5 avenue Foch, 29200, Brest, France,
Vernacular Title:
Bedeutung der Lernkurve und technischer Veränderungen für die Dosimetrie bei der Low-Dose-Brachytherapie des Prostatakarzinoms.
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