Prostate cancer brachytherapy:: Is real-time ultrasound-based dosimetry predictive of subsequent CT-based dose distribution calculation?: A study of 450 patients by the Institut Curie/Hospital Cochin (Paris) Group

被引:33
作者
Chauveinc, L
Flam, T
Solignac, S
Thiounn, N
Firmin, F
Debré, B
Rosenwald, JC
Phlips, P
Cosset, JM
机构
[1] Inst Curie, Unite Curietherapie, Dept Oncol Radiotherapy, F-75248 Paris 05, France
[2] Inst Curie, Dept Radiat Phys, F-75248 Paris 05, France
[3] Inst Curie, Dept Surg, F-75248 Paris 05, France
[4] Hosp Cochin, Dept Urol, Paris, France
[5] Hop Necker Enfants Malad, Dept Urol, Paris, France
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2004年 / 59卷 / 03期
关键词
prostate cancer; brachytherapy; dosimetry; intraoperative planning;
D O I
10.1016/j.ijrobp.2003.12.003
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: Real-time ultrasound (US)-based dosimetry performed during 1251 loose seed implantation provides the radiation oncologist with an estimation of the dose distribution at seed insertion. However, for a number of reasons, this distribution may not reflect the real (reference) dosimetry as determined by subsequent CT, usually performed 1-2 months after implantation. The present study compared the two dosimetry data sets (US and CT) to evaluate how predictive extemporaneous US-based dosimetry can be of the real dose distribution. Methods and Materials: A total of 450 patients with prostate cancer were treated with loose 1251 seed implantation between June 1999 and October 2002 by the Institut Curie/Hospital Cochin (Paris) Group. The mean patient age was 65 years. Most patients (74%) had Stage T1c; the stage did not exceed T2b for the others. All patients had a prostate-specific antigen level of <15 ng/mL and was <10 ng/mL for 72%; 84% had a Gleason score of :56 and did not exceed 7 for the others; and 56% were treated with neoadjuvant hormonal therapy for a mean of 4.3 months. All patients were treated with loose seed implantation. Real-time US-based dosimetry was performed intraoperatively for all patients. CT-based dosimetry was performed 2 months after implantation, using the VariSeed software. The minimal dose to 90% of the outlined volume (D-90) and percentage of volume receiving at least 100% of the prescribed dose (V-100) were calculated with the two methods and compared for all patients. Results: On CT-based dosimetry, the D-90 was found to be greater than or equal to145 Gy (range, 115-240 Gy) in all patients except one. A large majority (86%) of patients showed a CT-based V-100 of >95%, and 48% had a V-100 of >98%. The mean CT-based D-90/US-based D-90 ratio was 1.0 (range, 0.66-1.33). For 89% of the patients, the difference between the two values was <20% and for 62% was <10%. The mean CT-based V-100/US-based V-100 ratio was 0.98 (range, 0-1.02), with 89% of patients showing a difference of <5%. Conclusion: Our results indicate that the D-90 and V-100 values obtained intraoperatively with our real-time US-based dosimetry are in reasonable agreement with the subsequent values obtained with CT-based dosimetry performed 2 months after implantation. Recent innovations in our dose planning software allowed better control of the longitudinal seed position and could still improve the correlation between real-time US-based dosimetry and the subsequent CT-based dose distribution. (C) 2004 Elsevier Inc.
引用
收藏
页码:691 / 695
页数:5
相关论文
共 21 条
  • [11] American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer
    Nag, S
    Beyer, D
    Friedland, J
    Grimm, P
    Nath, R
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1999, 44 (04): : 789 - 799
  • [12] Timing of computed tomography-based postimplant assessment following permanent transperineal prostate brachytherapy
    Prestidge, BR
    Bice, WS
    Kiefer, EJ
    Prete, JJ
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 40 (05): : 1111 - 1115
  • [13] Radioisotopic implantation for carcinoma of the prostate: Does it work better than it used to?
    Prestidge, BR
    [J]. SEMINARS IN RADIATION ONCOLOGY, 1998, 8 (02) : 124 - 131
  • [14] A survey of physics and dosimetry practice of permanent prostate brachytherapy in the United States
    Prete, JJ
    Prestidge, BR
    Bice, WS
    Friedland, JL
    Stock, RG
    Grimm, PD
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 40 (04): : 1001 - 1005
  • [15] Stock R G, 2000, Tech Urol, V6, P95
  • [16] Postimplant dosimetry for 125I prostate implants:: Definitions and factors affecting outcome
    Stock, RG
    Stone, NN
    Lo, YC
    Malhado, N
    Kao, J
    DeWyngaert, JK
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2000, 48 (03): : 899 - 906
  • [17] A dose-response study for I-125 prostate implants
    Stock, RG
    Stone, NN
    Tabert, A
    Iannuzzi, C
    DeWyngaert, JK
    [J]. INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1998, 41 (01): : 101 - 108
  • [18] Stone N N, 1995, Tech Urol, V1, P72
  • [19] Intraoperative dynamic dosimetry for prostate implants
    Todor, DA
    Zaider, M
    Cohen, GN
    Worman, MF
    Zelefsky, MJ
    [J]. PHYSICS IN MEDICINE AND BIOLOGY, 2003, 48 (09) : 1153 - 1171
  • [20] ZALEFSKY MJ, 2003, INT J RAD BIOL PHYS, V55, P956