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Kato M, Higashi S, Sugino Y, Kajiwara S, Tanaka S, Kitano G, Yamashita Y, Ogura Y, Tachibana H, Kojima T, Inoue T. Clinical Efficacy and Openness to New Challenges of Low Dose Rate Brachytherapy for Prostate Cancer. Curr Oncol 2023; 30:9824-9835. [PMID: 37999133 PMCID: PMC10670683 DOI: 10.3390/curroncol30110713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/02/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023] Open
Abstract
Over a century ago, low-dose-rate (LDR) brachytherapy was introduced to treat prostate cancer (PCa). Since then, it has been widely applied worldwide, including in East Asia. LDR brachytherapy has been performed in 88 institutes in Japan. Beneficial clinical outcomes of LDR brachytherapy for intermediate-to-high-risk PCa have been demonstrated in large clinical trials. These clinical outcomes were achieved through advances in methods, such as urological precise needle puncture and seed placement, and the quantitative decision making regarding radiological parameters by radiation oncologists. The combined use of LDR brachytherapy with other therapeutic modalities, such as external beam radiation and androgen deprivation therapy, for the clinical risk classification of PCa has led to better anticancer treatment efficacy. In this study, we summarized basic LDR brachytherapy findings that should remain unchanged and be passed down in urology departments. We also discussed the applications of LDR brachytherapy for PCa in various clinical settings, including focal and salvage therapies. In addition, we highlighted technologies associated with brachytherapy that are under development.
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Affiliation(s)
- Manabu Kato
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Shinichiro Higashi
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Yusuke Sugino
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shinya Kajiwara
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
| | - Shiori Tanaka
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Goshi Kitano
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | | | - Yuji Ogura
- Kuwana City Medical Center, Urology, Kuwana 511-0061, Japan;
| | - Hiroyuki Tachibana
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Kojima
- Aichi Cancer Center, Urology, Nagoya 464-8681, Japan; (S.T.); (G.K.); (H.T.); (T.K.)
| | - Takahiro Inoue
- Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, Tsu 514-0001, Japan; (S.H.); (Y.S.); (S.K.); (T.I.)
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Westendorp H, Surmann K, van de Pol SM, Hoekstra CJ, Kattevilder RA, Nuver TT, Moerland MA, Slump CH, Minken AW. Dosimetric impact of contouring and image registration variability on dynamic 125 I prostate brachytherapy. Brachytherapy 2017; 16:572-578. [DOI: 10.1016/j.brachy.2017.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/30/2022]
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Westendorp H, Hoekstra CJ, Immerzeel JJ, van de Pol SMG, Niël CGHJ, Kattevilder RAJ, Nuver TT, Minken AW, Moerland MA. Cone-beam CT-based adaptive planning improves permanent prostate brachytherapy dosimetry: An analysis of 1266 patients. Med Phys 2017; 44:1257-1267. [PMID: 28192614 DOI: 10.1002/mp.12156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/12/2017] [Accepted: 02/08/2017] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To evaluate adaptive planning for permanent prostate brachytherapy and to identify the prostate regions that needed adaptation. METHODS AND MATERIALS After the implantation of stranded seeds, using real-time intraoperative planning, a transrectal ultrasound (TRUS)-scan was obtained and contoured. The positions of seeds were determined on a C-arm cone-beam computed tomography (CBCT)-scan. The CBCT-scan was registered to the TRUS-scan using fiducial gold markers. If dose coverage on the combined image-dataset was inadequate, an intraoperative adaptation was performed by placing remedial seeds. CBCT-based intraoperative dosimetry was analyzed for the prostate (D90, V100, and V150) and the urethra (D30). The effects of the adaptive dosimetry procedure for Day 30 were separately assessed. RESULTS We analyzed 1266 patients. In 17.4% of the procedures, an adaptation was performed. Without the dose contribution of the adaptation Day 30 V100 would be < 95% for half of this group. On Day 0, the increase due to the adaptation was 11.8 ± 7.2% (1SD) for D90 and 9.0 ± 6.4% for V100. On Day 30, we observed an increase in D90 of 12.3 ± 6.0% and in V100 of 4.2 ± 4.3%. For the total group, a D90 of 119.6 ± 9.1% and V100 of 97.7 ± 2.5% was achieved. Most remedial seeds were placed anteriorly near the base of the prostate. CONCLUSION CBCT-based adaptive planning enables identification of implants needing adaptation and improves prostate dose coverage. Adaptations were predominantly performed near the anterior base of the prostate.
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Affiliation(s)
- Hendrik Westendorp
- Department of Medical Physics, Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Carel J Hoekstra
- Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Jos J Immerzeel
- Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Sandrine M G van de Pol
- Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Charles G H J Niël
- Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Robert A J Kattevilder
- Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Tonnis T Nuver
- Department of Medical Physics, Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - André W Minken
- Department of Medical Physics, Department of Radiation Oncology, Radiotherapiegroep behandellocatie Deventer, Nico Bolkesteinlaan 85, 7416 SE, Deventer, The Netherlands
| | - Marinus A Moerland
- Department of Medical Physics, Department of Radiation Oncology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Westendorp H, Nuver TT, Hoekstra CJ, Moerland MA, Minken AW. Edema and Seed Displacements Affect Intraoperative Permanent Prostate Brachytherapy Dosimetry. Int J Radiat Oncol Biol Phys 2016; 96:197-205. [DOI: 10.1016/j.ijrobp.2016.04.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 03/10/2016] [Accepted: 04/11/2016] [Indexed: 11/25/2022]
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