Brachytherapy最新文献

{"title":"Multicenter study on mechanical accuracy of short dwell time and source transit for HDR Ir-192 brachytherapy treatment machine","authors":"Yoshihiro Ueda ,&nbsp;Hiroyuki Okamoto ,&nbsp;Yoshifumi Oku ,&nbsp;Yasushi Ono ,&nbsp;Jun Takatsu ,&nbsp;Jun-ichi Fukunaga ,&nbsp;Takahiro Ushijima ,&nbsp;Masahiko Toyota ,&nbsp;Kotaro Iijima ,&nbsp;Naoya Murakami ,&nbsp;Tatsuya Ohno","doi":"10.1016/j.brachy.2025.09.018","DOIUrl":"10.1016/j.brachy.2025.09.018","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the accuracy of the effective transit and dwell times for high-dose-rate (HDR) brachytherapy machines across multiple institutions. The aim was to establish reference levels for quality assurance (QA) in MicroSelectron and Flexitron afterloaders.</div></div><div><h3>METHODS</h3><div>The effective transit time of the amount of charge from the moving source divided by the current value and the short dwell times were measured using institution-owned well-type ionization chambers for 11 treatment machines from 10 institutions, including MicroSelectron and Flexitron afterloaders. Measurements were performed under standardized conditions to minimize variability, including controlled distances from walls and floors to reduce scattered radiation. The proportionality constants and effective transit times were calculated and the dwell times were measured for settings ranging from 0.1 to 30 s. For each afterloader, effective transit time and dwell time accuracy were measured five times, and the averages were used for analysis.</div></div><div><h3>RESULTS</h3><div>MicroSelectron afterloaders exhibited mean effective transit times of 0.90–1.05 s, whereas Flexitron afterloaders showed shorter times of 0.54–0.62 s. For the dwell time accuracy, MicroSelectron afterloaders exhibited a mean error of −0.048 to 0.104 s, with larger variability across institutions. In contrast, Flexitron afterloaders showed a mean error consistently below ±0.01 s, even at shorter dwell times. The variability in dwell time was notably significant higher for MicroSelectron than for Flexitron afterloaders (<em>p</em> ≤ 0.002).</div></div><div><h3>CONCLUSIONS</h3><div>This study demonstrates clear performance differences between MicroSelectron and Flexitron afterloaders in HDR brachytherapy and provides reference levels that support device-specific QA protocols to improve treatment precision and ensure consistent outcomes across institutions.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 145-153"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508403","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":"Automatic digitization of applicator and catheters for MRI-guided cervical cancer brachytherapy","authors":"Gayoung Kim ,&nbsp;Majd Antaki ,&nbsp;Ehud J. Schmidt ,&nbsp;Michael Roumeliotis ,&nbsp;Akila N. Viswanathan ,&nbsp;Junghoon Lee","doi":"10.1016/j.brachy.2025.09.017","DOIUrl":"10.1016/j.brachy.2025.09.017","url":null,"abstract":"<div><h3>PURPOSE</h3><div>MRI is the standard imaging modality for contouring organs-at-risk and clinical target volume in cervical cancer brachytherapy, and is widely used along with CT for treatment planning and image guidance. However, MRI-CT fusion-based approach is time-consuming and error-prone as it requires two imaging sessions and image registration. To realize more efficient and streamlined MRI-guided workflow, we propose an automatic method for digitizing the applicator and catheters using MRI alone.</div></div><div><h3>METHODS</h3><div>Applicator digitization consists of applicator mesh reconstruction, applicator ring identification, and alignment of the mesh model with MRIs. For catheter digitization, we employ an uncertainty-aware deep-learning model that simultaneously segments catheters and computes uncertainty on its prediction. These uncertainty facilitate initial localization of the catheters and subsequent refinement.</div></div><div><h3>RESULTS</h3><div>This study was performed on 35 T2-weighted MRIs from 30 cervical cancer patients treated with the Venezia applicator. The dataset was divided into 80% for development and 20% for testing. The method successfully digitized all applicators, with mean translation and rotation errors of 1.13 ± 0.26 mm and 2.19 ± 2.09°, respectively. All catheters except one were successfully digitized with shaft and tip errors of 0.74 ± 0.32 mm and 2.52 ± 2.04 mm, respectively. Furthermore, plans derived from the automatic digitization showed no significant differences compared to clinical plans (<em>p</em> &gt; 0.05).</div></div><div><h3>CONCLUSION</h3><div>The proposed MRI-based applicator and catheters digitization simplifies the brachytherapy planning process by eliminating the need for CT and manual tasks. Our results demonstrate that this approach is feasible and can be integrated into clinical workflows, offering potential improvements in efficiency and accuracy.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 85-94"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472561","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":"Assessment of brachytherapy-induced prostate edema on postimplant dosimetric analysis in patients treated with magnetic resonance imaging–assisted radiosurgery (MARS)","authors":"Kathryn E. Marqueen ,&nbsp;Kelsey L. Corrigan ,&nbsp;Surendra Prajapati ,&nbsp;Rajat J. Kudchadker ,&nbsp;Gohar Manzar ,&nbsp;Elaine Cha ,&nbsp;Henry Mok ,&nbsp;Chad Tang ,&nbsp;Comron Hassanzadeh ,&nbsp;Osama Mohamad ,&nbsp;Steven J. Frank","doi":"10.1016/j.brachy.2025.09.005","DOIUrl":"10.1016/j.brachy.2025.09.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Brachytherapy-induced prostate edema (PE) can result in altered target dose coverage in prostate cancer patients treated with low-dose-rate (LDR) brachytherapy. While visualization of PE on CT is limited, PE is evident on magnetic resonance imaging (MRI) day 0 (D0) postimplant assessment, a critical step in the MRI-assisted radiosurgery (MARS) framework that improves LDR brachytherapy quality assurance. This study investigated PE in patients treated with MARS to analyze the effect on postimplant dosimetry and further optimize the treatment-planning process.</div></div><div><h3>Materials and Methods</h3><div>We identified 317 patients with low-risk to intermediate-risk prostate cancer treated with cesium-131, iodine-125, or palladium-103 MARS definitive monotherapy from 2016 to 2021. Postimplant dosimetry was performed using MRI on D0. Simple linear regression with Pearson correlation analysis and ordinary ANOVA were used for analysis.</div></div><div><h3>Results</h3><div>The median D0 prostate volume was 29% higher (IQR, 16%–42%) compared with preimplant measurement, with no significant differences in PE magnitude by isotope (<em>p</em> = 0.33) or number of needles implanted (<em>p</em> = 0.70). PE magnitude decreased with increasing preplan prostate size (<em>p</em> &lt; 0.001). Greater PE was associated with decreased D0 prostate V₁₀₀ (<em>p</em> &lt; 0.001), V₁₅₀ (<em>p</em> &lt; 0.001), and D₉₀ (<em>p</em> &lt; 0.001), but was not associated with V₂₀₀ (<em>p</em> = 0.06), and &gt;98% implants achieved D₉₀/prescription dose &gt;90%. Greater PE was associated with decreased rectum V₁₀₀ (<em>p</em> = 0.02).</div></div><div><h3>Conclusions</h3><div>MRI on D0 confirmed PE after LDR brachytherapy. PE was not significantly different between isotopes, supporting the use of the same preplan target-volume margins among isotopes. Greater PE was associated with decreased prostate V₁₀₀, V₁₅₀, and D₉₀, without significant impact on overall implant quality.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 24-30"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574962","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":"Combined operative and radiotherapeutic treatment for locally recurrent gynaecologic cancer with pelvic wall invasion: A monocentric retrospective study","authors":"Selnur Özkurt ,&nbsp;Eva Oldenburger ,&nbsp;Vincent Tambeur ,&nbsp;Laurence Delombaerde ,&nbsp;Thaïs Baert ,&nbsp;Ignace Vergote ,&nbsp;Toon Van Gorp ,&nbsp;Els Van Nieuwenhuysen ,&nbsp;Marisol De Brabandere ,&nbsp;An Nulens ,&nbsp;Hilde Janssen ,&nbsp;Erik Van Limbergen ,&nbsp;Melissa Christiaens","doi":"10.1016/j.brachy.2025.09.003","DOIUrl":"10.1016/j.brachy.2025.09.003","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Managing locally recurrent gynecologic cancer with pelvic wall invasion, particularly after prior pelvic radiotherapy, presents a significant clinical challenge. Combined operative and radiotherapeutic treatment (CORT) is a potential curative approach. This study aims to evaluate the effectiveness and morbidity of this technique in this patient population as implemented within a single institution.</div></div><div><h3>METHODS AND MATERIALS</h3><div>A comprehensive, retrospective analysis was conducted on patients treated with CORT for recurrent gynecologic cancer with pelvic wall invasion after prior pelvic radiotherapy at the University Hospitals of Leuven between January 2000 and December 2023.</div></div><div><h3>RESULTS</h3><div>A total of 21 patients were eligible for analysis. All patients underwent open surgical macroscopic tumor resection with intraoperative implantation of brachytherapy guiding tubes. The average radiation dose to 90% of the treatment volume (D90) was 45.6 Gy EQD2 (range 16.0 to 66.2 Gy). The median follow-up period was 37.8 months (range 3–230 months). Local control at 2 and 5 years was 87,4% and 77,8%; overall-survival at 2 and 5 years was 57,1% and 52,4%, respectively. Seventeen of the 21 patients experienced some form of adverse event, with 15 patients needing surgical re-intervention.</div></div><div><h3>CONCLUSIONS</h3><div>Our retrospective analysis demonstrates high local control and favorable overall-survival outcomes in patients with recurrent gynecologic cancer involving the pelvic wall. However, the treatment is associated with a substantial risk of severe adverse events. Given the complexity and potential morbidity of this approach, CORT should be performed in specialized centers with experience in managing such cases.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 56-62"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314290","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":"Development of a phantom and analysis of brachytherapy dosimetry using the sulfamic acid/electron paramagnetic resonance system","authors":"Ghizlane Boukhris ,&nbsp;Mohammed Mikou ,&nbsp;Omar El Rhazouani ,&nbsp;Redouane El Baydaoui ,&nbsp;Sofia Jebbari ,&nbsp;Abdeslam Bouk ,&nbsp;Dounia Kamal","doi":"10.1016/j.brachy.2025.10.002","DOIUrl":"10.1016/j.brachy.2025.10.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Design and develop an epoxy resin-based cylindrical phantom to simulate cancer treatment conditions in high dose rate (HDR) brachytherapy and evaluate the spatial dose distribution around a ¹⁹²Ir source using an Sulfamic Acid/EPR system.</div></div><div><h3>METHODS AND MATERIALS</h3><div>A cylindrical phantom was fabricated from epoxy resin, allowing the precise insertion of a ¹⁹²Ir HDR brachytherapy source and multiple sulfamic acid dosimeters at predefined positions. The dosimetric system used in this study combined sulfamic acid detectors with EPR readout to quantify absorbed doses. Dosimeters were irradiated with doses ranging from 1 to 8 Gy, and the EPR signal intensities were measured to construct a calibration curve. Several dosimeters were then strategically positioned at various distances from the source to experimentally determine the dose distribution within the phantom.</div></div><div><h3>RESULTS</h3><div>The EPR dosimetry system showed a linear dose-response relationship within the 1-8 Gy range. The absorbed dose values at different locations were derived from the established calibration curve. A steep dose gradient was observed near the ¹⁹²Ir source, in agreement with theoretical expectations for HDR brachytherapy. The overall uncertainty in the dose evaluation process was estimated to be approximately 8% (<em>k</em> = 2).</div></div><div><h3>CONCLUSIONS</h3><div>This study demonstrates that the EPR/sulfamic acid dosimetry system provides a reliable and accurate method for dose evaluation in HDR brachytherapy. The developed epoxy resin phantom offers a practical and reproducible platform for experimental dose verification and quality assurance in brachytherapy treatments.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 136-144"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477149","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":"MRI-based predictors of treatment failure in intermediate-risk prostate cancer treated with high-dose-rate brachytherapy as monotherapy","authors":"Jacob F. Oyeniyi ,&nbsp;Joseph S. Lee ,&nbsp;Chen Shen ,&nbsp;Bailey A. Loving ,&nbsp;Sirisha R. Nandalur ,&nbsp;Andrew B. Thompson ,&nbsp;Kiran R. Nandalur ,&nbsp;Zachary A. Seymour ,&nbsp;Evelyn L. Sebastian ,&nbsp;Amy Limbacher ,&nbsp;Alvaro Martinez ,&nbsp;Daniel J. Krauss","doi":"10.1016/j.brachy.2025.10.012","DOIUrl":"10.1016/j.brachy.2025.10.012","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>To identify MRI features associated with treatment failure in intermediate-risk prostate cancer patients treated with HDR brachytherapy monotherapy.</div></div><div><h3>METHODS</h3><div>We analyzed 115 men with intermediate-risk prostate cancer who underwent definitive HDR brachytherapy as monotherapy and had pretreatment MRI within 6 months. MRI features assessed included lesion size, focality, location, capsular contact (yes vs. no, with no gross extracapsular extension), length of capsular contact, and PIRADS score. Univariable and multivariate logistic regression analyses were performed to identify MRI features associated with treatment failure, defined as biochemical recurrence and/or local recurrence.</div></div><div><h3>RESULTS</h3><div>The median age was 64 years, and median pretreatment PSA 5.95 ng/mL; 49 patients had favorable and 66 had unfavorable intermediate-risk disease. At 47 months median follow-up, 19 patients (16.5%) experienced treatment failure. MRI features associated with treatment failure on UVA included lesion size (OR: 3.9, CI: 1.8–8.8, <em>p</em> &lt; 0.001), multifocality (OR: 2.9, CI: 1.0–7.9, <em>p</em> = 0.043), capsular contact (OR: 64.3, CI: 8.1–510.0, <em>p</em> &lt; 0.001), capsular contact length ≥1 cm (OR: 5.0, CI: 1.6–15.7, <em>p</em> = 0.006), and PIRADS 5 (OR: 16.7, CI: 2.7–324.8, <em>p</em> = 0.011). On MVA, only capsular contact remained significant (OR: 57.2, CI: 9.5–106.2, <em>p</em> &lt; 0.001). In patients with capsular contact (<em>n</em> = 39), ADT significantly reduced treatment failure (OR: 0.101, CI: 0.002–0.912, <em>p</em> = 0.023).</div></div><div><h3>CONCLUSION</h3><div>Capsular contact on MRI is a strong independent predictor of treatment failure in intermediate-risk prostate cancer patients undergoing HDR brachytherapy as monotherapy. The addition of ADT significantly decreased the odds of treatment failure in these patients. These findings highlight the value of MRI-based risk stratification and suggest that treatment intensification options such as ADT could be considered to optimize treatment outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 15-23"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566797","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":"Salvage brachytherapy for local recurrence of prostate cancer. Evaluation of technique and dose fractionation, impact of early diagnosis, and its effect on survival. A multicenter retrospective observational study: RESPRO","authors":"Patricia Willisch ,&nbsp;Elena Villafranca ,&nbsp;Susana Roldan Ortega ,&nbsp;Silvia Rodriguez Villalba ,&nbsp;Alai Goñi ,&nbsp;Juan Adrian Camus ,&nbsp;Luis Sopeña Sanz ,&nbsp;Ana Alonso García ,&nbsp;Teresa Muñoz Miguelañez ,&nbsp;Saul Lopez-Soliño ,&nbsp;Beatriz Vázquez-Barreiro ,&nbsp;David Büchser","doi":"10.1016/j.brachy.2025.09.014","DOIUrl":"10.1016/j.brachy.2025.09.014","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate oncologic outcomes, prognostic factors, and toxicity associated with salvage brachytherapy in locally recurrent prostate cancer after radiotherapy and assess the role of next-generation imaging in early detection.</div></div><div><h3>METHODS</h3><div>A retrospective, multicenter cohort study was conducted including 188 patients treated with salvage HDR or LDR brachytherapy, with or without androgen deprivation therapy (ADT), across 10 Spanish centers. Primary endpoints were biochemical relapse-free survival (bRFS), clinical relapse-free survival (CRFS), and overall survival (OS). Survival probabilities were estimated using the Kaplan-Meier method, and predictive factors assessed using Cox proportional hazards models.</div></div><div><h3>RESULTS</h3><div>With a median follow-up of 64.6 months, 5- and 10-year bRFS were 64.9% and 61.7%, and CRFS were 72.3% and 68.1%, respectively. OS at 5 and 10 years was 97.9% and 93.6%. Time to PSA nadir and lower nadir values were associated with improved bRFS and CRFS. Gleason score &gt;7 and higher PSA at recurrence predicted worse outcomes. Next-generation imaging enhanced early detection. BED &gt;216 Gy improved control but raised urinary toxicity. Grade 3 acute and late urinary toxicity rates were 2.8% and 3.1%, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>Salvage brachytherapy is an effective option for locally recurrent prostate cancer. PSA dynamics and advanced imaging improve patient selection. BED optimization remains critical.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 31-39"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582812","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":"Development of a dosimetric phantom using OSLDs or TLD-100 for external audits of high-dose-rate 192Ir brachytherapy sources: Preliminary results","authors":"Carla L․ Mota ,&nbsp;Carlos Eduardo de Almeida ,&nbsp;Vanessa M․ Castro ,&nbsp;Aneli O․ da Silva ,&nbsp;Yvone Maria M․ Hornos ,&nbsp;Maria de Fátima A․ Magon ,&nbsp;Daniel Villani","doi":"10.1016/j.brachy.2025.09.013","DOIUrl":"10.1016/j.brachy.2025.09.013","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Calibration and quality control are fundamental to ensure that an accurate dose is delivered to a tumor, by HDR 192Ir radioactive sources in brachytherapy treatments. Consequently, it is essential for each radiation oncology center to implement a quality assurance program that includes an external audit. A cost-effective strategy, to meet the biannual requirements of licensing authorities, is the use of a well-established postal audit system employing phantoms and passive detectors.</div></div><div><h3>METHODS</h3><div>The primary aim of this study was to design and construct a PMMA phantom measuring 14 × 14 × 14 cm³, featuring a rectangular insert with 1 slot on each side capable of accommodating either a single Al₂O₃:C OSLD or 4 LiF-100 TLD chips, along with a central channel for positioning the 192Ir source. The source is aligned perpendicular to the geometric center of the detectors to optimize dose measurements while minimizing geometric effects. Both the phantom and detector modalities were tested using a Nucletron HDR 192Ir source and its TPS. Correction factors were determined to increase measurement accuracy.</div></div><div><h3>RESULTS</h3><div>The developed system demonstrates sufficient accuracy to meet the ±5% acceptance criterion for remote audits of HDR 192Ir brachytherapy sources.</div></div><div><h3>CONCLUSIONS</h3><div>Following successful testing, it is now intended to cover the 106 brachytherapy centers in Brazil, with the potential for expansion to additional centers throughout Latin America. The feasibility of using both detector types has been positively confirmed, offering flexibility and robustness to the audit system.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 241-250"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582830","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":"Impact of locoregional treatment intensification in stampede high-risk M0 prostate cancer patients","authors":"Jackson Howell,&nbsp;Jonathan Tward","doi":"10.1016/j.brachy.2025.09.006","DOIUrl":"10.1016/j.brachy.2025.09.006","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>This study evaluates the efficacy of locoregional treatment intensification with combined modality therapy (CMT) for STAMPEDE high-risk (SHR) nonmetastatic (M0) prostate cancer. We compare metastasis-free survival (MFS) and overall survival (OS) between external beam radiation therapy (EBRT) with androgen deprivation therapy (ADT), CMT with a brachytherapy boost, and up-front surgery.</div></div><div><h3>MATERIAL AND METHODS</h3><div>A retrospective cohort of 217 SHR patients from our institutional database was stratified by treatment modality: EBRT + ADT (<em>n</em> = 56), CMT (<em>n</em> = 61), and surgery (<em>n</em> = 100). Median ADT duration was 24 months for the EBRT + ADT group and 6 months for the CMT group. Primary outcomes were MFS and OS, analyzed using Cox proportional hazards regression and Fine-Gray competing risks models, adjusted for PSA, age, and Gleason group.</div></div><div><h3>RESULTS</h3><div>CMT significantly improved adjusted MFS compared to EBRT + ADT (HR 0.41; <em>p</em> = 0.004). In contrast, up-front surgery did not significantly improve MFS over EBRT + ADT (HR 0.84; <em>p</em> = 0.471). Adjusted OS was also superior with CMT compared to EBRT + ADT (HR 1.98; <em>p</em> = 0.025). On subgroup analysis, the MFS benefit of CMT persisted for N0 patients but not for N1 patients. A key limitation is the retrospective, nonrandomized nature of the data.</div></div><div><h3>DISCUSSION AND CONCLUSIONS</h3><div>Locoregional treatment intensification with CMT and de-intensified ADT offers significant oncologic benefits in men with SHR M0 prostate cancer, particularly in N0 patients. These findings support further investigation into combining brachytherapy and systemic therapy with de-intensified ADT in prospective trials.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 1-8"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305012","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":"Integration of single-click, AI-based brachytherapy auto-planning for cervical cancer within a treatment planning system","authors":"Ryan Truong ,&nbsp;Lance C. Moore ,&nbsp;Aranyo Mitra ,&nbsp;Karoline Kallis ,&nbsp;Kelly Kisling ,&nbsp;Nuno Vasconcelos ,&nbsp;Sandra M. Meyers","doi":"10.1016/j.brachy.2025.08.004","DOIUrl":"10.1016/j.brachy.2025.08.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Previous work developed an automated cervical brachytherapy treatment planning pipeline consisting of a U-Net dose prediction model and dwell time optimizer. While this method can produce clinically acceptable plans, it relies on time-consuming, manual export and import of DICOM data. This study proposes to increase efficiency by combining scripts into an all-in-one tool that can be used directly within the BrachyVision treatment planning system, producing automated plans in a single click.</div></div><div><h3>Materials and Methods</h3><div>We developed an AI-based planning tool through four main tasks; data retrieval, model inference, dwell time optimization, and auto-plan import. First, a C# plug-in interacts with the currently open patient in BrachyVision. Next, for data retrieval, model inference, and dwell time optimization, a Python executable operates on the data before the optimized dwell times are copied back into the open plan in BrachyVision. The script was tested on 28 brachytherapy plans spanning 7 applicator types, and auto-plans were compared to clinical plans using mean absolute error (MAE) in voxel-based 3D dose and dwell times.</div></div><div><h3>Results</h3><div>The average (± standard deviation) MAE in 3D dose and dwell times were 3.8 ± 0.7% (normalized to the prescribed dose) and 10.3 ± 7.4 s (2.1 ± 0.9% of the total plan dwell time), respectively. The average runtime of the script was 3.5 ± 1.2 minutes.</div></div><div><h3>Conclusions</h3><div>We developed a script that enables efficient, streamlined auto-planning directly within BrachyVision. After contouring and digitization are performed, the script can be run to produce high-quality, customized plans with a single button-click in a few minutes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 206-213"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357028","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}