Alfonso Gomez-Iturriaga1, Francisco Casquero2, Arantza Urresola3, Ana Ezquerro3, Jose I Lopez4, Jose M Espinosa5, Pablo Minguez5, Roberto Llarena6, Ana Irasarri7, Pedro Bilbao2, Juanita Crook8. 1. Hospital Universitario Cruces/Biocruces Health Research Institute, Radiation Oncology, Barakaldo, Spain. Electronic address: agomeziturriaga@gmail.com. 2. Hospital Universitario Cruces/Biocruces Health Research Institute, Radiation Oncology, Barakaldo, Spain. 3. Hospital Universitario Cruces, Radiology, Barakaldo, Spain. 4. Hospital Universitario Cruces/Biocruces Health Research Institute, Barakaldo, Spain. 5. Hospital Universitario Cruces, Physics, Barakaldo, Spain. 6. Hospital Universitario Cruces, Urology, Barakaldo, Spain. 7. Hospital Universitario Cruces/Biocruces Health Research Institute, Clinical Epidemiology Unit, Barakaldo, Spain. 8. Cancer Center for the Southern Interior, Radiation Oncology, British Columbia Cancer Agency, Kelowna, Canada.
Abstract
BACKGROUND AND PURPOSE: To demonstrate the feasibility, safety and effectiveness of dose escalation to intraprostatic lesions with MRI-transrectal ultrasound fusion High-Dose-Rate (HDR) brachytherapy. MATERIALS AND METHODS: 15 patients with intermediate-high risk prostate cancer and visible dominant intra-prostatic nodule on mpMRI have been treated. The treatment consisted of combined MRI-TRUS fusion HDR-brachytherapy (1 fraction of 1500cGy) and hypofractionated external beam (3750cGy in 15 fractions). A dose of 1875Gy was delivered to at least 98% of the DIL volume. RESULTS: Median prostate volume was 23.8cc; median number of needles was 16 (13-18). Dose escalation to DIL was feasible in 14/15 patients (93%) without violating dosimetric constraints and 1 patient presented a minimal deviation of dosimetric restrictions. With a median follow-up of 18months (17-24), none of the patients developed acute urinary retention or grade ⩾3 toxicity. In addition to standard PSA follow-up, response has been assessed by mpMRI at 12months. All patients presented adequate morphological responses on anatomical and functional sequences. CONCLUSIONS: HDR brachytherapy using MRI-transrectal ultrasound fusion for image guidance is a suitable technique for partial prostate dose escalation. Tolerance and toxicity profiles are excellent and results are encouraging in terms of biochemical, morphological and functional response.
BACKGROUND AND PURPOSE: To demonstrate the feasibility, safety and effectiveness of dose escalation to intraprostatic lesions with MRI-transrectal ultrasound fusion High-Dose-Rate (HDR) brachytherapy. MATERIALS AND METHODS: 15 patients with intermediate-high risk prostate cancer and visible dominant intra-prostatic nodule on mpMRI have been treated. The treatment consisted of combined MRI-TRUS fusion HDR-brachytherapy (1 fraction of 1500cGy) and hypofractionated external beam (3750cGy in 15 fractions). A dose of 1875Gy was delivered to at least 98% of the DIL volume. RESULTS: Median prostate volume was 23.8cc; median number of needles was 16 (13-18). Dose escalation to DIL was feasible in 14/15 patients (93%) without violating dosimetric constraints and 1 patient presented a minimal deviation of dosimetric restrictions. With a median follow-up of 18months (17-24), none of the patients developed acute urinary retention or grade ⩾3 toxicity. In addition to standard PSA follow-up, response has been assessed by mpMRI at 12months. All patients presented adequate morphological responses on anatomical and functional sequences. CONCLUSIONS: HDR brachytherapy using MRI-transrectal ultrasound fusion for image guidance is a suitable technique for partial prostate dose escalation. Tolerance and toxicity profiles are excellent and results are encouraging in terms of biochemical, morphological and functional response.
Authors: J V Hegde; D J Margolis; P-C Wang; R E Reiter; J Huang; M L Steinberg; M Kamrava Journal: Prostate Cancer Prostatic Dis Date: 2017-01-31 Impact factor: 5.554
Authors: Marko Rak; Tim König; Klaus D Tönnies; Mathias Walke; Jens Ricke; Christian Wybranski Journal: Int J Comput Assist Radiol Surg Date: 2017-07-06 Impact factor: 2.924
Authors: Luke A Matkovic; Tonghe Wang; Yang Lei; Oladunni O Akin-Akintayo; Olayinka A Abiodun Ojo; Akinyemi A Akintayo; Justin Roper; Jeffery D Bradley; Tian Liu; David M Schuster; Xiaofeng Yang Journal: Phys Med Biol Date: 2021-12-07 Impact factor: 3.609
Authors: Almudena Zapatero; Maria Roch; Pablo Castro Tejero; David Büchser; Carmen Martin de Vidales; Saturnino González; Pablo Rodríguez; Luis Alberto San Jose; Guillermo Celada; Maria Teresa Murillo Journal: Br J Radiol Date: 2021-09-19 Impact factor: 3.039
Authors: Tonghe Wang; Robert H Press; Matt Giles; Ashesh B Jani; Peter Rossi; Yang Lei; Walter J Curran; Pretesh Patel; Tian Liu; Xiaofeng Yang Journal: Br J Radiol Date: 2019-04-09 Impact factor: 3.039
Authors: Esther Mayrata; Jose Maria Espinosa; David Büchser; Francisco Casquero; Fernan Suárez; Alba González; Pablo Minguez; Jose Fernando Pérez; Iñigo San Miguel; Jon Cacicedo; Alfonso Gómez-Iturriaga Journal: J Contemp Brachytherapy Date: 2021-02-18
Authors: I-Chow Hsu; Joseph P Rodgers; Katsuto Shinohara; James Purdy; Jeff Michalski; Mack Roach; Eric Vigneault; Robert A Ivker; Rodger M Pryzant; Michael Kuettel; Daniel Taussky; Gary S Gustafson; Adam Raben; Howard M Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2020-11-10 Impact factor: 8.013