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 Vol 6: Pre-plan parameters predict post-implant D90 >= 140 Gy for 125I permanent prostate implants.


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This article is from Journal of Contemporary Brachytherapy, volume 6.AbstractPurpose: To find permanent prostate implant PPI pre-plan dosimetric parameters that predict post-implant D90 ≥ 140 Gy. Material and methods: Pre-plans were evaluated for 504 patients undergoing PPI with 125I seeds for low or intermediate risk prostate cancer. Baseline patient and disease factors, numbers of seeds, ratios of number of seeds to available positions occupancy proportion, and distances between the 100% isodose line and edge of the prostate margin planned for the whole prostate WP, superior S, inferior I, anterior A, and posterior P halves, SA, SP, IA, and IP quarters, and superior ST, inferior IT, and middle MT thirds, and anterior AT and posterior PT middle one-sixth segments were analyzed by post-implant D90 subset ≥ 140 Gy vs. 140 Gy. Results: 20% had post-implant D90 140 Gy mean: 128.0 Gy, range: 97.5-139.2 vs. ≥ 140 Gy mean: 154.4 Gy, range: 140.0-193.5. The D90 ≥ 140 Gy subset had larger AT and IA segment mean numbers of seeds p = 0.01, 0.046, larger WP, S, A, SA, ST, AT, and MT segment mean margins p = 0.01, 0.01, 0.001, 0.0001, 0.03, 0.005, 0.02, and lower PT segment occupancy proportion p = 0.004. On multivariate analysis, independent predictors of post-implant D90 ≥ 140 Gy were increased SA mean margin, no pre-implant 5-α-reductase inhibitor, higher pre-plan D90, decreased P occupancy proportion, no pre-implant hormone therapy, and decreased SP mean margin. Conclusions: Higher occupancy proportion and larger margins anteriorly and reduced occupancy proportion, and smaller margins posteriorly on PPI pre-plans predict post-implant D90 ≥ 140 Gy.



Autor: Alexander, Jes; Weinberg, Vivian; Gottschalk, Alexander R.; Hsu, I-Chow Joe; Shinohara, Katsuto; Roach, Mack

Fuente: https://archive.org/



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