Document Detail

A small tolerance for catheter displacement in high-dose rate prostate brachytherapy is necessary and feasible.
MedLine Citation:
PMID:  19616901     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We examined catheter displacement in patients treated with fractionated high-dose rate (HDR) brachytherapy boost for prostate cancer and the impact this had on tumor control probability (TCP). These data were used to make conclusions on an acceptable amount of displacement. METHODS AND MATERIALS: The last 20 patients treated with HDR brachytherapy boost for prostate cancer at our center in 2007 were replanned using simulated interstitial catheter displacements of 3, 6, 9, and 12 mm with originally planned dwell times. The computer-modeled dose-volume histograms for the clinical target volumes were exported and used to calculate the TCP of plans with displaced needles relative to the original plan. Actual catheter displacements were also measured before and after manual adjustment in all patients treated in 2007. RESULTS: In the 20 patients who were replanned for caudal catheter displacements of 3, 6, 9, and 12 mm, the median relative TCP was 0.998, 0.964, 0.797, and 0.265, respectively (p < 0.01 when all medians were compared). All patients replanned with a 3-mm displacement, compared with only 75% with a 6-mm displacement, had a relative TCP greater than 0.950. In the 91 patients treated in 2007, before adjustment, 82.3% of fractions had a displacement greater than 3 mm compared with 12.2% of fractions after adjustment. CONCLUSIONS: Catheter displacement in HDR brachytherapy significantly compromises the TCP. The tolerance for these movements should be small (< or =3 mm). Correcting these displacements to within acceptable limits is feasible.
Albert Tiong; Sean Bydder; Martin Ebert; Nikki Caswell; David Waterhouse; Nigel Spry; Peter Camille; David Joseph
Publication Detail:
Type:  Journal Article     Date:  2009-07-18
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  76     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-08     Completed Date:  2010-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1066-72     Citation Subset:  IM    
Copyright Information:
Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.
Department of Radiation Oncology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, Western Australia 6009, Australia.
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MeSH Terms
Aged, 80 and over
Brachytherapy / instrumentation*,  methods
Catheters, Indwelling*
Feasibility Studies
Middle Aged
Prostatic Neoplasms / radiography,  radiotherapy*
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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