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Chen ZJ, Li XA, Brenner DJ, Hellebust TP, Hoskin P, Joiner MC, Kirisits C, Nath R, Rivard MJ, Thomadsen BR, Zaider M. AAPM Task Group Report 267: A joint AAPM GEC-ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy. Med Phys 2024; 51:3850-3923. [PMID: 38721942 DOI: 10.1002/mp.17062] [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: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/08/2024] [Indexed: 06/05/2024] Open
Abstract
Brachytherapy utilizes a multitude of radioactive sources and treatment techniques that often exhibit widely different spatial and temporal dose delivery patterns. Biophysical models, capable of modeling the key interacting effects of dose delivery patterns with the underlying cellular processes of the irradiated tissues, can be a potentially useful tool for elucidating the radiobiological effects of complex brachytherapy dose delivery patterns and for comparing their relative clinical effectiveness. While the biophysical models have been used largely in research settings by experts, it has also been used increasingly by clinical medical physicists over the last two decades. A good understanding of the potentials and limitations of the biophysical models and their intended use is critically important in the widespread use of these models. To facilitate meaningful and consistent use of biophysical models in brachytherapy, Task Group 267 (TG-267) was formed jointly with the American Association of Physics in Medicine (AAPM) and The Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GEC-ESTRO) to review the existing biophysical models, model parameters, and their use in selected brachytherapy modalities and to develop practice guidelines for clinical medical physicists regarding the selection, use, and interpretation of biophysical models. The report provides an overview of the clinical background and the rationale for the development of biophysical models in radiation oncology and, particularly, in brachytherapy; a summary of the results of literature review of the existing biophysical models that have been used in brachytherapy; a focused discussion of the applications of relevant biophysical models for five selected brachytherapy modalities; and the task group recommendations on the use, reporting, and implementation of biophysical models for brachytherapy treatment planning and evaluation. The report concludes with discussions on the challenges and opportunities in using biophysical models for brachytherapy and with an outlook for future developments.
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Affiliation(s)
- Zhe Jay Chen
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - X Allen Li
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - David J Brenner
- Center for Radiological Research, Columbia University Medical Center, New York, New York, USA
| | - Taran P Hellebust
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Peter Hoskin
- Mount Vernon Cancer Center, Mount Vernon Hospital, Northwood, UK
- University of Manchester, Manchester, UK
| | - Michael C Joiner
- Department of Radiation Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Christian Kirisits
- Department of Radiation Oncology, Medical University of Vienna, Vienna, Austria
| | - Ravinder Nath
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mark J Rivard
- Department of Radiation Oncology, Brown University School of Medicine, Providence, Rhode Island, USA
| | - Bruce R Thomadsen
- Department of Medical Physics, University of Wisconsin, Madison, Wisconsin, USA
| | - Marco Zaider
- Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
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Strouthos I, Karagiannis E, Zamboglou N, Ferentinos K. High-dose-rate brachytherapy for prostate cancer: Rationale, current applications, and clinical outcome. Cancer Rep (Hoboken) 2021; 5:e1450. [PMID: 34164950 PMCID: PMC8789612 DOI: 10.1002/cnr2.1450] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022] Open
Abstract
Background High‐dose‐rate brachytherapy (HDR BRT) has been enjoying rapid acceptance as a treatment modality offered to selected prostate cancer patients devoid of risk group, employed either in monotherapy setting or combined with external beam radiation therapy (EBRT) and is currently one of the most active clinical research areas. Recent findings This review encompasses all the current evidence to support the use of HDR BRT in various clinical scenario and shines light to the HDR BRT rationale, as an ultimately conformal dose delivery method enabling safe dose escalation to the prostate. Conclusion Valid long‐term data, both in regard to the oncologic outcomes and toxicity profile, support the current clinical indication spectrum of HDR BRT. At the same time, this serves as solid, rigid ground for emerging therapeutic applications, allowing the technique to remain in the spotlight alongside stereotactic radiosurgery.
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Affiliation(s)
- Iosif Strouthos
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus.,Clinical Faculty, School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Efstratios Karagiannis
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus.,Clinical Faculty, School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Nikolaos Zamboglou
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus.,Clinical Faculty, School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Konstantinos Ferentinos
- Department of Radiation Oncology, German Oncology Center, Limassol, Cyprus.,Clinical Faculty, School of Medicine, European University Cyprus, Nicosia, Cyprus
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Radioactive seed migration following parotid gland interstitial brachytherapy. Brachytherapy 2017; 16:1219-1224. [PMID: 28927732 DOI: 10.1016/j.brachy.2017.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
PURPOSE To evaluate the incidence and associated factors of pulmonary seed migration after parotid brachytherapy using a novel migrated seed detection technique. METHODS AND MATERIALS Patients diagnosed with parotid cancer who underwent permanent parotid brachytherapy from January 2006 to December 2011 were reviewed retrospectively. Head and neck CT scans and chest X-rays were evaluated during routine follow-up. Mimics software and Geomagic Studio software were used for seed reconstruction and migrated seed detection from the original implanted region, respectively. Postimplant dosimetry analysis was performed after seeds migration if the seeds were still in their emitting count. Adverse clinical sequelae from seed embolization to the lung were documented. RESULTS The radioactive seed implants were identified on chest X-rays in 6 patients. The incidence rate of seed migration in 321 parotid brachytherapy patients was 1.87% (6/321) and that of individual seed migration was 0.04% (6/15218 seeds). All migrated seeds were originally from the retromandibular region. No adverse dosimetric consequences were found in the target region. Pulmonary symptoms were not reported by any patient in this study. CONCLUSIONS In our patient set, migration of radioactive seeds with an initial radioactivity of 0.6-0.7 mCi to the chest following parotid brachytherapy was rare. Late migration of a single seed from the central target region did not affect the dosimetry significantly, and patients did not have severe short-term complications. This study proposed a novel technique to localize the anatomical origin of the migrated seeds during brachytherapy. Our evidence suggested that placement of seeds adjacent to blood vessels was associated with an increased likelihood of seed migration to the lungs.
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Lee H, Lee WS, Park JI, Son KJ, Park M, Bang YB, Choy YB, Ye SJ. Surface coating for prevention of metallic seed migration in tissues. Med Phys 2016; 42:2805-12. [PMID: 26127032 DOI: 10.1118/1.4919445] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE In radiotherapy, metallic implants often detach from their deposited sites and migrate to other locations. This undesirable migration could cause inadequate dose coverage for permanent brachytherapy and difficulties in image-guided radiation delivery for patients. To prevent migration of implanted seeds, the authors propose a potential strategy to use a biocompatible and tissue-adhesive material called polydopamine. METHODS In this study, nonradioactive dummy seeds that have the same geometry and composition as commercial I-125 seeds were coated in polydopamine. Using scanning electron microscopy and x-ray photoelectron spectroscopy, the surface of the polydopamine-coated and noncoated seeds was characterized. The detachment stress between the two types of seeds and the tissue was measured. The efficacy of polydopamine-coated seed was investigated through in vitro migration tests by tracing the seed location after tissue implantation and shaking for given times. The cytotoxicity of the polydopamine coating was also evaluated. RESULTS The results of the coating characterization have shown that polydopamine was successfully coated on the surface of the seeds. In the adhesion test, the polydopamine-coated seeds had 2.1-fold greater detachment stress than noncoated seeds. From the in vitro test, it was determined that the polydopamine-coated seed migrated shorter distances than the noncoated seed. This difference was increased with a greater length of time after implantation. CONCLUSIONS The authors suggest that polydopamine coating is an effective technique to prevent migration of implanted seeds, especially for permanent prostate brachytherapy.
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Affiliation(s)
- Hyunseok Lee
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 151-742, Korea
| | - Won Seok Lee
- Interdisciplinary Program in Bioengineering, Seoul National University College of Engineering, Seoul 151-742, Korea
| | - Jong In Park
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 151-742, Korea
| | - Kwang-Jae Son
- Hanaro Applications Research, Korea Atomic Energy Research Institute, Daejeon 305-353, Korea
| | - Min Park
- Interdisciplinary Program in Bioengineering, Seoul National University College of Engineering, Seoul 151-742, Korea
| | - Young-bong Bang
- Advanced Institutes of Convergence Technology, Seoul National University, Suwon 443-270, Korea
| | - Young Bin Choy
- Interdisciplinary Program in Bioengineering, Seoul National University College of Engineering, Seoul 110-744, Korea; Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 110-744, Korea; and Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 110-744, Korea
| | - Sung-Joon Ye
- Program in Biomedical Radiation Sciences, Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul 151-742, Korea; Advanced Institutes of Convergence Technology, Seoul National University, Suwon 443-270, Korea; and Department of Radiation Oncology, Seoul National University Hospital, Seoul 110-744, Korea
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Seed loss in prostate brachytherapy. Strahlenther Onkol 2016; 192:305-11. [DOI: 10.1007/s00066-016-0961-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/10/2016] [Indexed: 10/22/2022]
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Prostate: High-Dose Rate Brachytherapy in the Treatment of Clinically Organ-Confined Prostate Cancer. Brachytherapy 2016. [DOI: 10.1007/978-3-319-26791-3_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Evaluation of the dosimetric impact of loss and displacement of seeds in prostate low-dose-rate brachytherapy. J Contemp Brachytherapy 2015. [PMID: 26207108 PMCID: PMC4499516 DOI: 10.5114/jcb.2015.52127] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To analyze the seed loss and displacement and their dosimetric impact in prostate low-dose-rate (LDR) brachytherapy while utilizing the combination of loose and stranded seeds. MATERIAL AND METHODS Two hundred and seventeen prostate cancer patients have been treated with LDR brachytherapy. Loose seeds were implanted in the prostate center and stranded seeds in the periphery of the gland. Patients were imaged with transrectal ultrasound before implant and with computerized tomography/magnetic resonance imaging (CT/MR) one month after implant. The seed loss and displacement had been analyzed. Their impact on prostate dosimetry had been examined. The seed distribution beyond the prostate inferior boundary had been studied. RESULTS The mean number of seeds per patient that were lost to lung, pelvis/abdomen, urine, or unknown destinations was 0.21, 0.13, 0.03, and 0.29, respectively. Overall, 40.1% of patients had seed loss. Seed migration to lung and pelvis/abdomen occurred in 15.5% and 10.5% of the patients, respectively. Documented seed loss to urine was found in 3% of the patients while 20% of patients had seed loss to unknown destinations. Prostate length difference between pre-plan and post-implant images was within 6 mm in more than 98% of cases. The difference in number of seeds inferior to prostate between pre-plan and post-implant dosimetry was within 7 seeds for 93% of patients. At time of implant, 98% of seeds, inferior to prostate, were within 5 mm and 100% within 15 mm, and in one month post-implant 83% within 9 mm and 96.3% within 15 mm. Prostate post-implant V100, D90, and rectal wall RV100 for patients without seed loss were 94.6%, 113.9%, and 0.98 cm(3), respectively, as compared to 95.0%, 114.8%, and 0.95 cm(3) for the group with seed loss. CONCLUSIONS Seed loss and displacement have been observed to be frequent. No correlation between seed loss and displacement and post-plan dosimetry has been reported.
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Zaorsky NG, Harrison AS, Trabulsi EJ, Gomella LG, Showalter TN, Hurwitz MD, Dicker AP, Den RB. Evolution of advanced technologies in prostate cancer radiotherapy. Nat Rev Urol 2013; 10:565-79. [DOI: 10.1038/nrurol.2013.185] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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