[Dosimetric evaluation of interstitial high-dose-rate implants for localised prostate cancer]. 2007

Georgina Fröhlich, and Péter Agoston, and József Lövey, and András Somogyi, and János Fodor, and Tibor Major
Semmelweis Egyetem, Doktori Iskola, Budapest. gfrohlich@oncol.hu

OBJECTIVE Quantitative evaluation of dose distributions of high-dose-rate prostate implants in order to make a later comparison with clinical outcome. METHODS Treatment plans of 169 implants for 161 patients were evaluated using dose-volume histograms. The planning was based on transrectal US imaging and 10 Gy (100%) dose was prescribed to the surface of the prostate. The tolerance dose to urethra and rectum was 125% and 80%, respectively. The volume of the prostate was measured, and its fraction receiving 90%, 100%, 150% and 200% of the prescribed dose was calculated (V90, V100, V150, V200). The dose delivered to 90% of the prostate volume (D90) and the minimum dose in the prostate (Dmin) were determined. The dose nonuniformity ratio (DNR) and the dose homogeneity index (DHI) were calculated to quantify the dose homogeneity. The coverage index (CI) was determined, and the dose conformality to the target volume was assessed with the use of the conformal index (COIN). Maximal dose to rectum (Dr) and urethra (Du) reference points, dose to volume of 2 cm3 of the rectum (D2) and 0.1 cm3 and 1% of the urethra (D0.1, D1) were determined, too. Correlation analysis was performed between point and volume doses. In most patients in-vivo dose measurement was performed in the rectum with semiconductor detectors. RESULTS The median number of needles was 16, the mean prostate volume was 25.5 cm3. The mean V90, V100, V150 and V200 were 98%, 94%, 41% and 14%, respectively. The mean D90 was 107%, and the Dmin was 82%. The mean dose to rectum and urethra reference points was 75% and 120%, respectively. The mean volume doses were D2=49% for the rectum, D0.1=128% and D1=143% for the urethra. The correlation coefficients were: R(Dr,D2)=0.69, R(Du,D0.1)=0.55, R(Du,D1)=0.23. The mean DNR was 0.39, while the DHI was 0.57. On average, 94% of the target volume received at least the prescribed dose (CI=0.94) and the mean COIN was 0.64. The mean maximal measured dose in the rectum was 2.67 Gy. CONCLUSIONS Our US-based treatment plans based on the real positions of catheters provided acceptable dose distributions. In the majority of our cases the dose to urethra and rectum was kept below the defined tolerance level. The dose of rectal reference points correlated well with rectal dose-volume parameters but for urethra dose determination the use of the D1 volumetric parameter is recommended. Finding correlations between dose-volume parameters and clinical side effects requires further analysis.

UI MeSH Term Description Entries
D008297 Male Males
D011471 Prostatic Neoplasms Tumors or cancer of the PROSTATE. Cancer of Prostate,Prostate Cancer,Cancer of the Prostate,Neoplasms, Prostate,Neoplasms, Prostatic,Prostate Neoplasms,Prostatic Cancer,Cancer, Prostate,Cancer, Prostatic,Cancers, Prostate,Cancers, Prostatic,Neoplasm, Prostate,Neoplasm, Prostatic,Prostate Cancers,Prostate Neoplasm,Prostatic Cancers,Prostatic Neoplasm
D011857 Radiographic Image Interpretation, Computer-Assisted Computer systems or networks designed to provide radiographic interpretive information. Computer Assisted Radiographic Image Interpretation,Computer-Assisted Radiographic Image Interpretation,Radiographic Image Interpretation, Computer Assisted
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D011880 Radiotherapy Planning, Computer-Assisted Computer-assisted mathematical calculations of beam angles, intensities of radiation, and duration of irradiation in radiotherapy. Computer-Assisted Radiotherapy Planning,Dosimetry Calculations, Computer-Assisted,Planning, Computer-Assisted Radiotherapy,Calculation, Computer-Assisted Dosimetry,Calculations, Computer-Assisted Dosimetry,Computer Assisted Radiotherapy Planning,Computer-Assisted Dosimetry Calculation,Computer-Assisted Dosimetry Calculations,Dosimetry Calculation, Computer-Assisted,Dosimetry Calculations, Computer Assisted,Planning, Computer Assisted Radiotherapy,Radiotherapy Planning, Computer Assisted
D011881 Radiotherapy, Computer-Assisted Computer systems or programs used in accurate computations for providing radiation dosage treatment to patients. Computer-Assisted Radiotherapy,Radiation Therapy, Computer-Assisted,Computer-Assisted Radiation Therapy,Computer Assisted Radiation Therapy,Computer Assisted Radiotherapy,Computer-Assisted Radiation Therapies,Computer-Assisted Radiotherapies,Radiation Therapies, Computer-Assisted,Radiation Therapy, Computer Assisted,Radiotherapies, Computer-Assisted,Radiotherapy, Computer Assisted,Therapies, Computer-Assisted Radiation,Therapy, Computer-Assisted Radiation
D001918 Brachytherapy A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. Curietherapy,Implant Radiotherapy,Plaque Therapy, Radioisotope,Radioisotope Brachytherapy,Radiotherapy, Interstitial,Radiotherapy, Intracavity,Radiotherapy, Surface,Brachytherapy, Radioisotope,Interstitial Radiotherapy,Intracavity Radiotherapy,Radioisotope Plaque Therapy,Radiotherapy, Implant,Surface Radiotherapy,Therapy, Radioisotope Plaque
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014463 Ultrasonography The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. Echography,Echotomography,Echotomography, Computer,Sonography, Medical,Tomography, Ultrasonic,Ultrasonic Diagnosis,Ultrasonic Imaging,Ultrasonographic Imaging,Computer Echotomography,Diagnosis, Ultrasonic,Diagnostic Ultrasound,Ultrasonic Tomography,Ultrasound Imaging,Diagnoses, Ultrasonic,Diagnostic Ultrasounds,Imaging, Ultrasonic,Imaging, Ultrasonographic,Imaging, Ultrasound,Imagings, Ultrasonographic,Imagings, Ultrasound,Medical Sonography,Ultrasonic Diagnoses,Ultrasonographic Imagings,Ultrasound, Diagnostic,Ultrasounds, Diagnostic
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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