Brachytherapy最新文献

{"title":"A retrospective study on ruthenium-106 and strontium-90 eye-plaques treatment for retinoblastoma: 16-years clinical experience","authors":"Andrey A. Yarovoy,&nbsp;Denis P. Volodin,&nbsp;Vera A. Yarovaya","doi":"10.1016/j.brachy.2024.11.008","DOIUrl":"10.1016/j.brachy.2024.11.008","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To retrospectively evaluate the efficacy of plaque brachytherapy for the treatment of retinoblastoma.</div></div><div><h3>METHODS</h3><div>We retrospectively reviewed the clinical records of 163 patients (186 eyes, 333 tumors) treated with brachytherapy (¹⁰⁶Ru or ⁹⁰Sr plaques) for intraocular retinoblastoma between November 2007 and August 2023.</div></div><div><h3>RESULTS</h3><div>Complete tumor control was achieved in 273 tumors (82%). Incomplete tumor control was observed in 44 tumors (13%). Thirteen tumors presented with tumor progression. Three tumors relapsed after brachytherapy. On multivariate statistical analysis apex dose ≤ 85 Gy (for ¹⁰⁶Ru) (<em>p</em> = 0.03), dark fundus pigmentation (<em>p =</em> 0.005) and intraarterial chemotherapy-brachytherapy period &lt; 2 months (<em>p</em> = 0.001) demonstrated significant effect on brachytherapy insufficiency.</div><div>Radiation-induced complications occurred in 62 eyes (33%). The most frequent complications were nonproliferative retinopathy (n = 39, 21%), optic neuropathy (n = 29, 16%) and vitreous hemorrhage (n = 29, 16%). Multivariate statistical analysis showed central localization (<em>p</em> = 0.005), tumor thickness &gt; 2.7 mm (p = 0.04) and larger plaque diameter (&gt;14 mm) (<em>p =</em> 0.035) to be the most significant variables for brachytherapy-associated complications.</div><div>Eye retention was achieved in 91% of the treated eyes (n = 169). 17 eyes (9%) were enucleated. The reasons for enucleation were tumor recurrence or uncontrolled tumor growth (n = 7), anterior chamber involvement (n = 3), recurrent active vitreous seeding (n = 1), inability of adequate tumor monitoring due to opaque media (dense total vitreous hemorrhage or total retinal detachment) (n = 3), subatrophy of the eye with functional blindness (n = 3).</div></div><div><h3>CONCLUSION</h3><div>Overall, Beta-ray brachytherapy proved to be a highly effective method of retinoblastoma treatment with excellent local tumor control, eye preservation rate and acceptable incidence of curable radiation-induced complications.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 265-272"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed radiopaque episcleral plaques with radioactive collimating cavities for enhanced dose delivery in brachytherapy","authors":"Souheib Zekraoui ,&nbsp;Théophraste Lescot ,&nbsp;Mahdokht Akbari Taemeh ,&nbsp;Marc-André Fortin","doi":"10.1016/j.brachy.2024.12.001","DOIUrl":"10.1016/j.brachy.2024.12.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Episcleral plaque brachytherapy (EPBT) is a well-established treatment. However, the lateral dose to healthy tissues, such as the sclera, retina, and optic nerve is often problematic and results in side effects. This study proposes an innovative approach based on the 3D-printing of radiopaque polymer plaques featuring cylindrical radioactive cavities (CRC) with a potential collimating effect on radiation delivery to tumors.</div></div><div><h3>METHODS AND MATERIALS</h3><div>A CAD model based on the COMS protocol was created and 3D-printed using radiopaque PEEK polymer. Cylindrical cavities (1 mm depth/diameter) were evenly spaced on the plaque's inner surface. Two radioactive layouts (RL₁: uniform loading; RL₂: radial gradient loading) were designed. µCT imaging was used to assess the geometric accuracy of the 3D-printed CRC EPs, and dose distribution was evaluated for the two (2) radioactive layouts using MAGIC-pf gel dosimetry and <em>T₂</em>-weighted MRI. The resulting dose profiles were compared with those generated by both COMS and SEP plaques.</div></div><div><h3>RESULTS</h3><div>Radiopaque CRC EPs showed higher central axis dose deposition while minimizing lateral overexposure compared to COMS and SEP plaques, while also providing robust back-shielding. Dose profiles from RL₁ CRC EPs (uniform layout) extended deeper into the eye, whereas RL₂ CRC EPs (with gradient) exhibited a more rapid dose fall-off, producing a concentrated, spherical dose distribution.</div></div><div><h3>CONCLUSIONS</h3><div>3D-printed radiopaque EPs with radioactivity encapsulated in cylindrical cavities demonstrated the ability to achieve more forward-projected dose profiles in EPBT. This fabrication design and a modulated radioactivity distribution across the EP surface would enable more precise and deeper dose delivery while reducing radiation exposure to lateral healthy tissues.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 354-363"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards U-Net-based intraoperative 2D dose prediction in high dose rate prostate brachytherapy","authors":"Eric Knull ,&nbsp;Christopher W. Smith ,&nbsp;Aaron D. Ward ,&nbsp;Aaron Fenster ,&nbsp;Douglas A. Hoover","doi":"10.1016/j.brachy.2024.11.007","DOIUrl":"10.1016/j.brachy.2024.11.007","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Poor needle placement in prostate high-dose-rate brachytherapy (HDR-BT) results in sub-optimal dosimetry and mentally predicting these effects during HDR-BT is difficult, creating a barrier to widespread availability of high-quality prostate HDR-BT.</div></div><div><h3>PURPOSE</h3><div>To provide earlier feedback on needle implantation quality, we trained machine learning models to predict 2D dosimetry for prostate HDR-BT on axial TRUS images.</div></div><div><h3>METHODS AND MATERIALS</h3><div>Clinical treatment plans from 248 prostate HDR-BT patients were retrospectively collected and randomly split 80/20 for training/testing. Fifteen U-Net models were implemented to predict the 90%, 100%, 120%, 150%, and 200% isodose levels in the prostate base, midgland, and apex. Predicted isodose lines were compared to delivered dose using Dice similarity coefficient (DSC), precision, recall, average symmetric surface distance, area percent difference, and 95th percentile Hausdorff distance. To benchmark performance, 10 cases were retrospectively replanned and compared against the clinical plans using the same metrics.</div></div><div><h3>RESULTS</h3><div>Models predicting 90% and 100% isodose lines at midgland performed best, with median DSC of 0.97 and 0.96, respectively. Performance declined as isodose level increased, with median DSC of 0.90, 0.79, and 0.65 in the 120%, 150%, and 200% models. In the base, median DSC was 0.94 for 90% and decreased to 0.64 for 200%. In the apex, median DSC was 0.93 for 90% and decreased to 0.63 for 200%. Median prediction time was 25 ms.</div></div><div><h3>CONCLUSION</h3><div>U-Net models accurately predicted HDR-BT isodose lines on 2D TRUS images sufficiently quickly for real-time use. Incorporating auto-segmentation algorithms will allow intra-operative feedback on needle implantation quality.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 328-338"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative high-dose-rate brachytherapy alone in stage T1-3N0M0 oral cancer with negative prognostic factors: A retrospective study","authors":"Luboš Tuček ,&nbsp;Igor Sirák ,&nbsp;Denisa Pohanková ,&nbsp;Linda Kašaová ,&nbsp;Jakub Grepl ,&nbsp;Petr Paluska ,&nbsp;Miroslav Hodek ,&nbsp;Milan Vošmik ,&nbsp;Banni Aml Mustafa ,&nbsp;Eva Čermánková ,&nbsp;Jiří Petera","doi":"10.1016/j.brachy.2024.03.001","DOIUrl":"10.1016/j.brachy.2024.03.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate treatment outcomes and toxicity in patients with stage T1-3N0M0 oral cancer treated with surgery followed by high-dose-rate brachytherapy (HDR-BT).</div></div><div><h3>Methods and materials</h3><div>Retrospective study of 50 patients with stage T1-T3N0 tongue and floor-of-mouth cancer who underwent tumour excision (+ elective neck dissection) followed by postoperative HDR-BT due to the presence of negative prognostic factors (close or positive resection margins, lymphovascular and/or perineural invasion, deep invasion). The plastic tube technique (dose: 18 x 3 Gy b.i.d.) was used. Survival outcomes, toxicity, and prognostic factors were evaluated.</div></div><div><h3>Results</h3><div>At a median follow-up of 81 months (range, 4-121), actuarial 5-year local control (LC), nodal control (NC) and progression-free survival (PFS) rates were 79%, 69%, and 64%. After salvage treatment (surgery + external beam radiotherapy), LC, NC, and PFS increased to 87%, 77%, and 72.3%, respectively. Five-year overall survival and cancer-specific survival (CSS) rates were 73% and 77%. Treatmentrelated toxicity included two cases of mandibular osteoradionecrosis and five cases of small soft tissue necrosis. T stage was significantly correlated with nodal control (p=0.02) and CSS (p=0.04). Tumour grade correlated with DFS (p=0.01).</div></div><div><h3>Conclusion</h3><div>Postoperative HDR-BT 18 x 3 Gy b.i.d. seems to be an effective method in patients with T1-3N0M0 oral cancer with negative prognostic factors after tumour resection.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 273-280"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of dose distribution to the tumor and organs at risk for cervical cancer patients treated using HDR-ICBT without central tandem applicator: A single center based experience","authors":"Jonasi A. Foya ,&nbsp;Mwingereza J. Kumwenda ,&nbsp;Khamis O. Amour ,&nbsp;Jofrey J. Masana","doi":"10.1016/j.brachy.2024.10.016","DOIUrl":"10.1016/j.brachy.2024.10.016","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Cervical cancer is the most prevalent type of cancer among women in numerous low and middle-income countries. Tandem-based applicator is a widely used technique in High Dose Rate Intercavitary Brachytherapy (HDR-ICBT) for treating cervical cancer. For cases where central tandem insertion is not feasible due to patient-specific conditions, a ring-only applicator is used as an alternative. This paper presents an assessment of the impacts of dose distribution on cervical cancer treatment using HDR-ICBT without a central tandem applicator.</div></div><div><h3>Materials and method</h3><div>Total 30 patients with cervical cancer (stage IB to IVA) who received brachytherapy with a ring applicator alone were singled out and used in the study. Orthogonal radiographs were used during dose treatment planning.</div></div><div><h3>Results</h3><div>Results indicate that the dose normalized to the Equivalent dose in 2 Gy fractions (EQD2) at Manchester Dosimetry System (MDS) point A was 60.60 ± 1.08 Gy, which is significantly below the recommended curative dose of 80 Gy. This suggests that relying solely on a ring applicator may not provide enough radiation doses to the tumor. The results also show that the International Commission on Radiation Units (ICRU) dose point underestimated the radiation doses to the bladder and rectum, with the ratios of maximum dose (<em>D_Max</em>) to <em>D_ICRU</em> for both organs being 1.15.</div></div><div><h3>Conclusion</h3><div>The study underscores the importance of not exclusively depending on a ring applicator alone in HDR-ICBT treatment for cervical cancer, as it may lead to suboptimal tumor doses. The ICRU point's results show an underestimation of the rectum and bladder dose during HDR-ICBT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 238-247"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curve and proficiency assessment for gynecological brachytherapy amongst radiation oncology trainees in India: Results from a prospective study","authors":"Bharath Kumar ,&nbsp;Prachi Mittal ,&nbsp;Ankita Gupta ,&nbsp;Jaahid Mulani ,&nbsp;Rajesh Bhajbhuje ,&nbsp;Sadhana Kannan ,&nbsp;Jeevanshu Jain ,&nbsp;Supriya Chopra","doi":"10.1016/j.brachy.2024.11.013","DOIUrl":"10.1016/j.brachy.2024.11.013","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The quality of cervical cancer intracavitary brachytherapy (ICBT) depends on the training and experience of the radiation oncologist (RO). The present study was performed to establish primary learning curve for ICBT.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Forty-three skill parameters were identified for performing ICBT and were included for Brachytherapy Proficiency Assessment and Scoring System (Brachy-PASS) questionnaire. Brachy-PASS score was first compared with blinded objective scoring of implant quality for 10 trainees by two ROs. Twenty eight consecutive trainees were scored with Brachy-PASS by two RO's. The impact of number of procedures and training years was ascertained using Mann Whitney-U test. Minimum number of intracavitary procedures to attain proficiency (score<span><math><mo>≥</mo></math></span> 75%) were ascertained and learning curve plot of proficiency and procedures was generated.</div></div><div><h3>RESULTS</h3><div>Between January, 2022 to September, 2023 38 trainees were evaluated (20: post graduate year (PGY) 1-3, and 18: PGY 4-5) after due consent for skill evaluation. Good congruence was reported of objective scoring and Brachy-PASS (83.4% vs 88%). Ten trainees had performed &lt;15 ICBT, and 28 had performed ≥15 ICBT procedures. Overall 30/38 trainees (78.9%) achieved a Brachy-PASS score of ≥129 (75%). The average score for trainees with &lt;15 procedures was 126.6 (73.6%) vs 148.8 (86.5%) in trainees who performed ≥15 procedures. PGY 4-5 trainees had higher score (153.8 (89.4%) vs 134 (77.9%)). Learning curve threshold of 15 ICBT was identified to attain 75% score (129/172) with no plateauing of learning curve even with <span><math><mo>≥</mo></math></span>30 procedures.</div></div><div><h3>CONCLUSION</h3><div>Competency is established for independently performing intracavitary brachytherapy at 15 procedures and further increase in competency scores continues with increasing procedures.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 339-347"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound and CT-guided implantation of iodine-125 seeds combined with transarterial chemoembolization for recurrent hepatocellular carcinoma at complex sites after hepatectomy","authors":"Yeyan Wang ,&nbsp;Jie Feng","doi":"10.1016/j.brachy.2024.12.002","DOIUrl":"10.1016/j.brachy.2024.12.002","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The objective of this study was to evaluate the efficacy and safety of TACE combined with 125I seeds (TACE-125I) in the treatment of recurrent HCC at complex sites after hepatectomy.</div></div><div><h3>METHODS</h3><div>This study retrospectively analyzed the clinical data of recurrent HCC patients located at complex sites (such as large blood vessels, diaphragm dome, etc.) after hepatectomy from January 2012 to December 2023, all of whom received TACE-125I or TACE therapy. Recur rence, overall survival (OS), progression-free survival (PFS) and complications were compared be tween the 2 groups.</div></div><div><h3>RESULTS</h3><div>A total of 152 patients with recurrent HCC were enrolled in this study, including 69 in the TACE-125I group and 83 in the TACE group. During follow-up, a total of 41 patients in the TACE-125I group experienced tumor recurrence, compared to 67 patients in the TACE group. The median OS in the TACE-125I group was 31 months, which was significantly higher than that in the TACE group (16 months, <em>p</em> &lt; 0.001). Similarly, the median PFS was significantly higher in the TACE-125I group than in the TACE group.</div></div><div><h3>CONCLUSIONS</h3><div>Compared with TACE treatment, TACE-125I may be a more effective method for the treatment of recurrent HCC located at complex sites.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 293-300"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and early outcomes of proton therapy and low-dose rate brachytherapy boost for patients with prostate cancer","authors":"Osama Mohamad ,&nbsp;Zakaria El Kouzi ,&nbsp;Ramez Kouzy ,&nbsp;Seungtaek Choi ,&nbsp;Henry Mok ,&nbsp;Karen Hoffman ,&nbsp;Quynh-Nhu Nguyen ,&nbsp;Comron J Hassanzadeh ,&nbsp;Chad Tang ,&nbsp;Ryan J Park ,&nbsp;Shalin Jyotindra Shah ,&nbsp;Sean Eric McGuire ,&nbsp;Lauren Layer Mayo ,&nbsp;Yusung Kim ,&nbsp;Surendra Prajapati ,&nbsp;Sarath Vijayan ,&nbsp;Rajat J Kudchadker ,&nbsp;Teresa Lorraine Bruno ,&nbsp;Steven Jay Frank","doi":"10.1016/j.brachy.2024.12.003","DOIUrl":"10.1016/j.brachy.2024.12.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Brachytherapy boost improves biochemical control for patients with prostate cancer. Here, we report the safety and early efficacy of proton therapy (PT) with a low-dose-rate (LDR) brachytherapy boost.</div></div><div><h3>METHODS</h3><div>This retrospective study included patients with intermediate- or high-risk prostate cancer treated with PT followed by LDR boost, with or without androgen deprivation therapy (ADT), from 2010 through 2023. Patient, disease, and treatment characteristics, gastrointestinal (GI) and genitourinary (GU) toxicity, and efficacy outcomes are reported.</div></div><div><h3>RESULTS</h3><div>Ninety-nine patients received PT and LDR boost; median age at diagnosis was 68 years (interquartile range [IQR] 61–72). Most patients (<em>n</em> = 77) were White, 12 were African American, 5 Asian, and 3 Hispanic. Thirty-five patients had intermediate-risk (4 favorable and 31 unfavorable), 56 had high-risk, and 8 had very high-risk disease. Median PT dose was 44 Gy(RBE) (range 40–50.4) and median LDR dose was 90Gy (range 90–110). Pd-103 seed strands were used for 95 patients and I-125 for 4; 90 had MRI-assisted radiosurgery brachytherapy; 91 received ADT; and 21 had a rectal spacer. At a median follow-up time of 45 months, 5-year biochemical recurrence-free survival was 98%. There was no local recurrence, distant metastasis, or cancer death. Four patients had acute urinary retention after brachytherapy procedure. Eleven patients (11%) had late grade 2 GU toxicity, and 3 (3%) had late grade 2 GI toxicity. One patient had grade 3 urethral stricture requiring dilatation and transurethral resection.</div></div><div><h3>CONCLUSIONS</h3><div>At 45 months' follow-up time, treatment with PT and LDR boost led to high control rates and low toxicity for men with prostate cancer.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 301-309"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HDR brachytherapy combined with external beam radiotherapy for unfavorable localized prostate cancer: A single center experience from inception to standard of care","authors":"Ka-Kit David Yeung ,&nbsp;Juanita Crook ,&nbsp;Gregory Arbour ,&nbsp;Cynthia Araujo ,&nbsp;Deidre Batchelar ,&nbsp;David Kim ,&nbsp;David Petrik ,&nbsp;Tracey Rose ,&nbsp;Francois Bachand","doi":"10.1016/j.brachy.2024.12.005","DOIUrl":"10.1016/j.brachy.2024.12.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>High dose rate (HDR) brachytherapy is increasingly adopted for dose escalation in prostate cancer treatment. We report the clinical efficacy and toxicity of HDR prostate brachytherapy combined with external beam radiotherapy (EBRT) and evaluate the predictability of the biochemical definition of cure of 4-year PSA ≤0.2 ng/mL for failure free survival (FFS).</div></div><div><h3>METHODS</h3><div>A single centre retrospective study was conducted, including all patients with high-tier intermediate risk and high-risk prostate cancer treated with HDR brachytherapy combined with EBRT from 2011 to 2019. Patient and prostate cancer characteristics, treatment, clinical endpoints, and follow up were collected.</div></div><div><h3>RESULTS</h3><div>Total 319 patients were analyzed. The median age was 68 with median follow up of 77.1 months. Total 142 had high-tier intermediate and 177 had high-risk disease. Brachytherapy doses were initially 20 Gy/2 fractions, and subsequently 15 Gy/1 fraction. All patients received 46 Gy/23 fractions of EBRT. Overall survival at 5 and 9 years was 92.2% and 77.0%, respectively. Failure-free survival (FFS) was 86.0% at 5 years and 76.1% at 9 years. PSA ≤ 0.2 ng/mL at 4 years was seen in 79.3% of patients and was associated with FFS of 94.1% at 9 years. Grade 3 urethral stricture, hematuria, or proctitis occurred in 2.8%, 0%, and 0%, respectively.</div></div><div><h3>CONCLUSION</h3><div>HDR brachytherapy in addition to EBRT is effective treatment for unfavourable localized prostate cancer with a very acceptable toxicity profile. The biochemical definition of cure of PSA &lt; 0.2 ng/mL at 4 years was predictive for FFS at 9 years.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 318-327"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From patient to pioneer: The inspiring journey of Dr. Brian Moran","authors":"Manuj Agarwal ,&nbsp;Peter Orio","doi":"10.1016/j.brachy.2024.11.002","DOIUrl":"10.1016/j.brachy.2024.11.002","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 199-209"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}