Publication: Optimal source distribution for focal boosts using high dose rate (HDR) brachytherapy alone in prostate cancer
Issued Date
2014-01-01
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ISSN
18790887
01678140
01678140
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2-s2.0-84922596472
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Mahidol University
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SCOPUS
Bibliographic Citation
Radiotherapy and Oncology. Vol.113, No.1 (2014), 121-125
Suggested Citation
Pittaya Dankulchai, Roberto Alonzi, Gerry J. Lowe, James Burnley, Anwar R. Padhani, Peter J. Hoskin Optimal source distribution for focal boosts using high dose rate (HDR) brachytherapy alone in prostate cancer. Radiotherapy and Oncology. Vol.113, No.1 (2014), 121-125. doi:10.1016/j.radonc.2014.09.001 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34579
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Title
Optimal source distribution for focal boosts using high dose rate (HDR) brachytherapy alone in prostate cancer
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Abstract
© 2014 Elsevier Ireland Ltd. All rights reserved. Purpose: To investigate the optimal distribution of sources using high dose rate brachytherapy to deliver a focal boost to a dominant lesion within the whole prostate gland based on multi-parametric magnetic resonance imaging (mpMRI). Methods: Sixteen patients with prostate cancer underwent mpMRI each of which demonstrated a dominant lesion. There were single lesions in 6 patients, two lesions in 4 and 3 lesions in 6 patients. Two dosimetric models and parameters were compared in each case. The first model used 10 mm intervals between needles, and the second model used additional needles at 5 mm intervals between each needle in the boost area. Results: Three of thirty-two plans did not achieve the plan objectives. These three plans were in the first model. A higher median urethral volume was seen in the 'unsuccessful' group (2.7 cc, and 1.9 cc, respectively, p-value = 0.12). Conformity indices of the second model were also better than the first model (COIN index; 0.716 and 0.643, respectively). Conclusions: Focal monotherapy based on mpMRI achieves optimal dosimetry by individualizing the needle positions using 5 mm spacing rather than 10 mm spacing within the boost volume. A larger urethral volume may have an adverse effect on this distribution. Formal clinical evaluation of this approach is currently underway.