Impact of urinary catheterization on dosimetry after prostate implant brachytherapy with palladium-103 or iodine-125

被引:3
作者
Shirvani, Shervin M.
Kudchadker, Rajat J. [2 ]
Bruno, Teresa L. [2 ]
Likhacheva, Anna
Swanson, David A. [3 ]
Frank, Steven J. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Unit 97, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Radiat Phys, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Urol, Houston, TX 77030 USA
关键词
Postimplant dosimetry; Prostate brachytherapy; Prostate cancer; Foley catheter; Catheterization; URETHRAL STRICTURES; CANCER;
D O I
10.1016/j.brachy.2010.12.001
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
PURPOSE: Postoperative dosimetry is integral to quality assurance for prostate brachytherapy. Images on Day 0 are typically obtained with a contrast-filled urinary catheter in place for urethral dose calculations. However, expansion of the urethra and perhaps the prostate by the catheter may affect target coverage. We assessed. the effect of urinary catheterization on target dosimetry after implantation with palladium-103 ((103)Pd) or iodine-125 ((125)I) seeds. METHODS AND MATERIALS: Patients were 29 consecutive men with postimplant dosimetry calculated with and without a urinary catheter after brachytherapy seed implantation; 19 patients received (103)Pd seeds and 10 patients received (125)I seeds. In each case, 14-French caude tip urinary catheters were placed before implantation, and axial CT slices of the pelvis were obtained before and after catheter removal for postimplant dosimetry. Dosimetric parameters were measured and compared with paired Student's t tests. Trends were assessed by linear regression with the Pearson correlation coefficient. RESULTS: Removal of the urinary catheter significantly improved V(100) and D(90) for (103)Pd implants (mean +/- standard deviation (SD), 2.7% +/- 4.2%; range, -0.4% to 15%; p = 0.011 and mean +/- SD, 4.0% +/- 3.4%; range, -0.1% to 13.8%; p < 0.01, respectively). For (125)I implants, catheter removal improved D(90) (mean +/- SD, 1.5% +/- 1.8%; range, -1.3% to 4.2%; p = 0.027). For the (103)Pd group, the magnitude of change in V(100) correlated with prostate size (R(2) = 0.16) and source number (R(2) = 0.15). CONCLUSIONS: Urinary catheterization can artificially reduce target coverage after prostate implant brachytherapy. The patients undergoing (103)Pd implantation with smaller (<30 cm(3)) prostates and fewer (<90) sources are particularly susceptible to reduced D(90) and V(100) when a urinary catheter is present. (C) 2011 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:269 / 274
页数:6
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