I-Chow Joe Hsu1, Yoshiya Yamada2, Dean G Assimos3, Anthony V D'Amico4, Brian J Davis5, Steven J Frank6, Alexander R Gottschalk7, Gary S Gustafson8, Patrick W McLaughlin9, Paul L Nguyen10, Seth A Rosenthal11, Al V Taira12, Neha Vapiwala13, Gregory Merrick14. 1. Depart of Radiation Oncology, University of California San Francisco, San Francisco, CA. Electronic address: IHsu@radonc.ucsf.edu. 2. Memorial Sloan Kettering Cancer Center, New York, NY. 3. University of Alabama at Birmingham School of Medicine, American Urological Association, Birmingham, AL. 4. Joint Center for Radiation Therapy, American Society of Clinical Oncology, Boston, MA. 5. Mayo Clinic, Rochester, MN. 6. MD Anderson Cancer Center, Houston, TX. 7. Depart of Radiation Oncology, University of California San Francisco, San Francisco, CA. 8. William Beaumont Hospital, Troy, MI. 9. University of Michigan, Novi, MI. 10. Dana-Farber Cancer Institute/Brigham and Women's Hospital, Boston, MA. 11. Radiological Associates of Sacramento and Sutter Cancer Center, Sacramento, CA. 12. Western Radiation Oncology, Mountain View Oncology, Mountain View, CA. 13. University of Pennsylvania Medical Center, Philadelphia, PA. 14. Schiffler Cancer Center and Wheeling Jesuit University, Wheeling, WV.
Abstract
PURPOSE: High-dose-rate (HDR) brachytherapy plays a potential curative role in the treatment of prostate cancer. An expert panel was convened to review the recent literature and reach a consensus on its appropriate clinical applications. METHODS AND MATERIALS: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. RESULTS: A summary of HDR brachytherapy's clinical applications and recent literature review was completed. Three clinical variants were developed to address common HDR dose, fractionations, and indications for its use in definitive therapy for primary and local recurrent prostate cancer. The panel reached a consensus on the specific treatment approaches with numerical rating and commentary. CONCLUSIONS: In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate application of HDR brachytherapy for prostate cancer.
PURPOSE: High-dose-rate (HDR) brachytherapy plays a potential curative role in the treatment of prostate cancer. An expert panel was convened to review the recent literature and reach a consensus on its appropriate clinical applications. METHODS AND MATERIALS: The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. RESULTS: A summary of HDR brachytherapy's clinical applications and recent literature review was completed. Three clinical variants were developed to address common HDR dose, fractionations, and indications for its use in definitive therapy for primary and local recurrent prostate cancer. The panel reached a consensus on the specific treatment approaches with numerical rating and commentary. CONCLUSIONS: In combining available medical literature and expert opinion, this manuscript may serve as an aid for other practitioners in the appropriate application of HDR brachytherapy for prostate cancer.
Authors: Tiffany M Morgan; Robert H Press; Patrick K Cutrell; Chao Zhang; Zhengjia Chen; Sara Rahnema; Jaymin Jhaveri; Martin Sanda; John Pattaras; Pretesh Patel; Ashesh B Jani; Peter J Rossi Journal: J Contemp Brachytherapy Date: 2018-06-30