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Comparison of low and intermediate source strengths for (125)I prostate brachytherapy implants.

By:
Contributors: Nawaid Usmani, MD, FRCPC, Sunita Ghosh, PhD
Brachytherapy. 2013 Sep-Oct;12(5):442-8. doi: 10.1016/j.brachy.2013.02.004. Epub 2013 May 23.

Abstract

PURPOSE:

To compare the implant quality and clinical outcomes for patients treated with low and intermediate strength (125)I seeds in prostate brachytherapy implants.

METHODS AND MATERIALS:

This retrospective review included 390 consecutive patients treated with prostate brachytherapy from 1999 to 2006. The first 142 patients were implanted with source strengths lower than 0.415U (0.327mCi), with the subsequent 248 patients implanted with source strengths higher than 0.493U (0.388mCi). Clinical, dosimetric, toxicity, and outcome data were compared between these two cohorts of patients.

RESULTS:

Despite having similar prostate volumes, fewer sources (median, 95 vs. 113; p<0.0001) and fewer needles (median, 23 vs. 29; p<0.0001) were implanted in the intermediate strength cohort. The postimplant dosimetry demonstrated better quality implants in patients treated with intermediate strength sources (median D90, 160.0Gy vs. 139.6Gy; p<0.0001), with greater dose inhomogeneity identified in the intermediate strength cohort of patients. A higher incidence of late rectal toxicity was identified in patients treated with intermediate strength sources despite lower rectal doses in this cohort. The biochemical relapse-free survival, prostate cancer survival, and overall survival were not significantly different between the two cohorts.

CONCLUSIONS:

The transition from low to intermediate strength sources has led to fewer resources being used and improved postoperative dosimetry. Although there were more rectal complications identified in the intermediate strength cohort of patients in this analysis, there were no other significantly worse clinical or biochemical outcomes for patients implanted with intermediate strength sources.

 

PubMed

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Member of the APCaRI Training Program will present a poster at CARO ASM 2017 – Toronto

Congratulations to Dr. Deepak Dinakaran for getting his abstract “Comparison of Post-Radiotherapy Prostate Specific Antigen drop kinetics between External Beam Radiotherapy and Brachytherapy” accepted as a poster presentation at the Canadian Association of Radiation Oncology Annual Scientific Meeting (CARO ASM) 2017.

The 2017 CARO Annual Scientific Meeting will be held at the Hilton Toronto in Toronto, ON September 13-16, 2017.  This conference is for Radiation Oncologists, Medical Physicists, Radiation Therapists, Basic Science Researchers, Oncology Nurses, Administrators, as well as their trainees. All healthcare professionals involved in the care of oncology patients are also welcome to attend.

Dr. Dinakaran extracted and analyzed clinical data from the Alberta Prostate Cancer Registry for this study.

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