169 Yb-based high dose rate intensity modulated brachytherapy for focal treatment of prostate cancer.

Autor: Robitaille M; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Electronic address: maude.robitaiile@mail.mcgill.ca., Ménard C; Department of Radiation Oncology, CHUM, Montreal, Quebec, Canada., Famulari G; Department of Radiation Oncology, Jewish General Hospital, Montreal, Quebec, Canada; Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada., Béliveau-Nadeau D; Department of Radiation Oncology, CHUM, Montreal, Quebec, Canada., Enger SA; Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada; Medical Physics Unit, Department of Oncology, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
Jazyk: angličtina
Zdroj: Brachytherapy [Brachytherapy] 2024 Sep-Oct; Vol. 23 (5), pp. 523-534. Date of Electronic Publication: 2024 Jul 21.
DOI: 10.1016/j.brachy.2024.05.005
Abstrakt: Purpose: This study compares conventional 192 Ir-based high dose rate brachytherapy (HDR-BT) with 169 Yb-based HDR intensity modulated brachytherapy (IMBT) for focal prostate cancer treatment. Additionally, the study explores the potential to generate less invasive treatment plans with IMBT by reducing the number of catheters needed to achieve acceptable outcomes.
Methods and Materials: A retrospective dosimetric study of ten prostate cancer patients initially treated with conventional 192 Ir-based HDR-BT and 5-14 catheters was employed. RapidBrachyMCTPS, a Monte Carlo-based treatment planning system was used to calculate and optimize dose distributions. For 169 Yb-based HDR IMBT, a custom 169 Yb source combined with 0.8 mm thick platinum shields placed inside 6F catheters was used. Furthermore, dose distributions were investigated when iteratively removing catheters for less invasive treatments.
Results: With IMBT, the urethra D 10 and D 0.1cc decreased on average by 15.89 and 15.65 percentage points (pp) and the rectum V 75 and D 2cc by 1.53 and 11.54 pp, respectively, compared to the conventional clinical plans. Similar trends were observed when the number of catheters decreased. On average, there was an observed increase in PTV V 150 from 2.84 pp with IMBT when utilizing all catheters to 8.83 pp when four catheters were removed. PTV V 200 increased from 0.42 to 2.96 pp on average. Hotspots in the body were however lower with IMBT compared to conventional clinical plans.
Conclusions: 169 Yb-based HDR IMBT for focal treatment of prostate cancer has the potential to successfully deliver clinically acceptable, less invasive treatment with reduced dose to organs at risk.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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