Radiation protection and dosimetry issues for patients with prostate cancer after I-125 low-dose-rate brachytherapy permanent implant
The aim of this work was to analyze the exposure rates measured in the proximity of patients who underwent prostate low-dose-rate brachytherapy with I-125 implant. Effective doses to relatives and to population were computed to estimate the time to reach radioprotection dose constraints.
Abstract •PIVOTALboost evaluates benefits/toxicity of pelvic node RT and focal boost dose escalation.•Unfavourable intermediate/high risk and bulky local disease are most likely to benefit.•Functional MRI imaging is used to select patients for different types of dose escalation.•HDR brachytherapy or focal dose escalation with IMRT are used as options.•Training and support is provided to reduce variations of contouring and radiotherapy planning.•The trial is recruiting patients in 38 radiotherapy centres through the UK. PMID: 32995575 [PubMed]
CONCLUSION: Prostate cancer treatment choices differ substantially between men diagnosed in private and public health services in Victoria. These differences are not explained by disease severity or comorbidity. PMID: 32996611 [PubMed - as supplied by publisher]
Mature results from randomised trials of external beam radiotherapy (EBRT) show that biochemical control of disease improves with increasing radiation dose [1 –4]. High-dose-rate afterloading brachytherapy (HDR-BT) can deliver a high, localised radiation dose to the prostate with excellent biochemical control of disease and has advantages over external beam radiotherapy (EBRT) because of its ability to overcome problems of organ movement, which confound the external beam techniques used [5–7]despite modern image guided approaches.
CONCLUSION: At 12 years there remains a significant improvement in RFS after EBRT + HDR-BTb; both treatments were equitoxic for severe late urinary and bowel events and urethral strictures. PMID: 33011207 [PubMed - as supplied by publisher]
The purpose of the study was to describe our approach towards safe delivery of single-fraction high-dose-rate (HDR) brachytherapy (BT) boost in patients with prostate cancer in the setting of an unshielded operating room (OR).
To investigate fully balanced steady-state free precession (bSSFP) with optimized acquisition protocols for MRI-based post-implant quality assessment of low-dose-rate (LDR) prostate brachytherapy without an endorectal coil (ERC).
The use of high-dose rate (HDR) brachytherapy in the treatment of prostate cancer is now well established. According to American Society of Clinical Oncology/Cancer Care Ontario brachytherapy guidelines , HDR- or Low Dose-Rate brachytherapy should be offered as a boost to external beam radiotherapy (EBRT) in eligible intermediate and high-risk patients and may be an option as monotherapy in patients with more favourable disease.
CONCLUSION: The overall rate of acute urinary complications post HDR brachytherapy is low, but the individual risk of urinary retention can increase depending on the number of risk factors present. A more patient-directed retention risk estimation can be performed by using the classification risk tree presented here. PMID: 32966843 [PubMed - as supplied by publisher]
CONCLUSION: OCPC treatment affects QoL. Curative monotherapies, specifically RP and BT, have less effect on QoL than external radiotherapy or other therapeutic alternatives. Urinary incontinence and fistulas secondary to OCPC have the highest impact on QOL impairment. The internationally validated SF 36 questionnaire is a useful cross-sectional measure of QOL to compare the impact of OCPC treatment modalities. PMID: 32950271 [PubMed - as supplied by publisher]
The natural history of radiorecurrent of high-risk prostate cancer (HRPCa) is poorly understood, despite the proportionally higher rates of BCR in this risk group. Treatment HRPCa with external beam radiotherapy (EBRT) plus brachytherapy (BT) boost (EBRT+BT) has been associated with lower rates of BCR, distant metastasis (DM), and PCa-specific mortality (PCSM) compared to EBRT alone. However, it is unclear whether patients who develop BCR following either approach have similar downstream oncologic outcomes.