Brachytherapy最新文献

{"title":"GPP03 Presentation Time: 9:18 AM","authors":"Umhes Mahantshetty MD ,&nbsp;Lavanya Gurram MD ,&nbsp;Raviteja Miriyala MD ,&nbsp;KK. Sreelakshmi DRP ,&nbsp;Ajeet Gandhi MD ,&nbsp;Abhishek Basu MD ,&nbsp;Harjot Kaur Bajwa MD ,&nbsp;Bhavana Rai MD ,&nbsp;V Srinivasan MD ,&nbsp;Manoj Gupta MD ,&nbsp;Rajesh Vashishta MD ,&nbsp;Primoz Petric MD ,&nbsp;Kari Tanderup PhD ,&nbsp;Christian Kirisits Ph.D ,&nbsp;Richard Potter MD","doi":"10.1016/j.brachy.2024.08.005","DOIUrl":"10.1016/j.brachy.2024.08.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Six teaching courses with focus on 3D IGABT for cervical cancer were conducted in India between 2017 &amp; 2023, as collaborative effort of AROI and ESTRO. The purpose is to report impact of teaching courses, as observed from pre-course surveys and a recent master survey of all course participants.</div></div><div><h3>Material and Methods</h3><div>Pre-course surveys were conducted before each of the six courses, where in information related to pre-course BT practice of each participating team (physician and physicist) was collected. Recently, a detailed online master survey was conducted to understand impact of courses on BT approach and practice.</div></div><div><h3>Results</h3><div>A total of 456 participants (344 physicians and 112 physicists) who were responsible for treating cervical cancer patients attended the courses. As per pre-course surveys, BT planning was frequently done using X rays, CT and MRI by 25%, 75% and 10% of participants respectively. Hybrid IC+IS and 3D dose prescription (to high-risk CTV) were commonly used by 31% and 35% participants. Among 456 participants, 104 teams (one team per institute was allowed to respond) from 104 centres responded (83 physicians and 21 physicists). Of these, 101 (97.1%) continued to practice cervical cancer brachytherapy at the time of the survey. Percentage-wise implementation/utilisation of various critical processes/resources in cervical cancer brachytherapy workflow at the time of master survey are presented in <strong>Figure 1</strong> (upper panel).Teaching course empowered participants in implementing/ improvising critical processes, like examination under anaesthesia (14%), clinical drawings (55%), ultrasound guidance (23%), IC+IS (32%), target volume delineation (46%) &amp; volume-based prescription (39%); however, these processes could be sustained in 8%, 32%, 17%, 25%, 41% and 33% centres, respectively,. (FIgure1 lower panel). Frequent reasons cited for inability to implement and sustain these critical processes include heavy patient load, lack of availability of infrastructure (dedicated ultrasonography, compatible applicators, access to MRI etc), suboptimal human resources (Anesthesiologists, Radiologists, Radiation Oncologists) etc.Among the participants, 94% and 87% felt that their knowledge and practice of BT improved substantially after the course, respectively. About 94% of the participants expressed interest in collaborative prospective research related to IGABT for cervical cancer.</div></div><div><h3>Conclusion</h3><div>Survey results suggest that the teaching courses substantially improved clinical workflow, use of ultrasonography for guidance, utilisation of pre-BT MR/MR/CT-TRUS based BT, advanced BT applications (IC + IS), target volume delineation and volumetric dose prescription. Majority of centres appear to be interested in exploring prospective research related to IGABT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526613","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":"MSOR3 Presentation Time: 5:10 PM","authors":"Zepaer Abudureheman MBBA ,&nbsp;Tao Zhu MBBA ,&nbsp;Dengyao Liu M.D., Ph.D.","doi":"10.1016/j.brachy.2024.08.037","DOIUrl":"10.1016/j.brachy.2024.08.037","url":null,"abstract":"<div><h3>Purpose</h3><div>The study aimed to evaluate the combined efficacy of systemic therapy and iodine-125 seed implantation as a local treatment in patients with oligometastatic non-small cell lung cancer (NSCLC), defined by ≤3 metastatic organs and ≤5 metastatic lesions, and to identify factors that influence patient outcomes.</div></div><div><h3>Materials and Methods</h3><div>A retrospective review was conducted of 40 patients with oligometastatic NSCLC treated from January 2018 to June 2023 at our institution. Patients were divided into Group A (n=20), receiving both systemic therapy and iodine-125 seed implantation, and Group B (n=20), treated with systemic therapy alone. The primary outcome was progression-free survival (PFS), with overall survival (OS) serving as a secondary outcome. Survival analysis for PFS and OS was performed using Kaplan-Meier curves, with the Log-rank test for intergroup comparisons, and Cox regression analysis was used for univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>The median PFS for Group A was 14.9 months (95% CI: 12.8-17.0), which was significantly longer than the 6.9 months (95% CI: 4.7-9.1) for Group B (HR=6.50, 95% CI: 4.60-9.20). The median OS was 28.7 months (95% CI: 19.5-37.9) for Group A, surpassing the 17.0 months (95% CI: 13.5-20.5) for Group B (HR=1.60, 95% CI: 1.05-2.40). Multivariate analysis highlighted intracranial metastasis as a significant risk factor for PFS. Influential factors for OS included oligometastatic status, the presence of brain metastases, histologic subtype, the use of immune checkpoint inhibitors (ICIs), driver mutations, anti-angiogenic treatments, and the implementation of iodine-125 seed implantation for local therapy.</div></div><div><h3>Conclusion</h3><div>In patients with oligometastatic NSCLC and stable primary lesions, the integration of systemic therapy with iodine-125 seed implantation markedly improves PFS and OS compared to systemic therapy alone. This underscores the value of iodine-125 seed implantation in the comprehensive treatment strategy, highlighting its significant role in enhancing patient survival outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526608","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":"MPP04 Presentation Time: 4:27 PM","authors":"Elena Dizendorf MD, PhD ,&nbsp;Alina Sturdza MD","doi":"10.1016/j.brachy.2024.08.018","DOIUrl":"10.1016/j.brachy.2024.08.018","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Education in brachytherapy (BT) is multidisciplinary and has multiple facets; industry plays here also a pivotal role. As image-guided brachytherapy (IGBT) experiences a rapid growth, companies are increasingly receiving requests from customers seeking education and practical skill training. Traditional product training for BT equipment is insufficient in addressing the educational requirements for IGBT. The objective of this study was to analyze the live clinical workshops (WS) conducted by the BrachyAcademy (BA) with the aim of enhancing the adoption of IGBT among radiation therapy professionals. Additionally, the study sought to evaluate the influence of BA WS on the clinical practice of the participants.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;The BA WS is designed for a limited group, typically a maximum of 10-20 participants. The workshop program, spanning 2 or 3 days, usually includes live observation of BT cases in the operating theater, hands-on training covering applicator/needles/catheters insertion, contouring, and treatment planning (TP), as well as lectures and discussions. The WS faculty comprises Radiation Oncologists (RO) and Medical Physicists (MP) from the hosting hospital, along with invited clinical experts. We gathered and examined data of the live clinical BA WS in hospitals globally from 2008 to 2023. In March 2020, BA initiated a survey to gather feedback from participants of the previous live WS. The survey sought insights into the workshop impact on their clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The inaugural BA WS, titled “IGBT for gynecology using the combined intracavitary/interstitial technique”, took place in July 2008 in collaboration with a reputable institution. Subsequently, a total of 28 gynecological workshops have been organized in the same place. These WS attracted 435 participants from 47 countries, including 243 RO, 179 MP, and 13 Radiation Therapy Technologists (RTT), who provided highly positive evaluations. Between 2008 and 2023, BrachyAcademy organized a total of 117 live clinical workshops (including the gynae workshops mentioned above), as illustrated in Figure 1, showcasing the distribution of WS based on BT indication and location. The reduced number of WS in 2020-2021 was a consequence of the COVID-19 pandemic. Over the 15-year period, the total number of WS by BT indication was as follows: gynecological - 53, prostate - 28, breast - 13, skin - 13, general BT for residents - 4, bladder - 3, rectal - 2, head and neck - 1. Geographically, the WS were distributed as follows: Europe - 68, North America - 30, Asia - 17, Africa - 1, Australia - 1. Based on 933 available evaluation forms filled by EG WS participants, 59% attendees rated their achievement of learning objectives as “very good,” while 39% rated it as “good”, and 2% as “neutral\". The overall workshop satisfaction score was 9 out of 10. In 2020, we received feedback on the survey from 64 pa","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526618","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":"PHSOR09 Presentation Time: 9:40 AM","authors":"Brian Hrycushko Ph.D.,&nbsp;Aurelie Garant MD,&nbsp;Zohaib Iqbal PhD,&nbsp;Yesenia Gonzalez PhD,&nbsp;Tiylar Cotton BS,&nbsp;David Sher MD, MPH,&nbsp;Kevin Albuquerque MD,&nbsp;Tsuicheng Chiu PhD","doi":"10.1016/j.brachy.2024.08.083","DOIUrl":"10.1016/j.brachy.2024.08.083","url":null,"abstract":"<div><h3>Purpose</h3><div>Plesio-brachytherapy offers a favorable option for treating skin cancer or keloids post-surgical excision, particularly on curved body surfaces. By closely conforming body contours, plesio-brachytherapy can provide a more uniform surface dose compared to suboptimal external beam techniques. Current HDR flap-based brachytherapy methods, although flexible in design, can be a challenge to shape to irregular surfaces where maintaining a consistent distance for the radioactive sources is paramount to treatment goals. To address these issues, this work proposes a customized flexible silicone applicator to achieve a better fit to the patient's body with minimal air gaps.</div></div><div><h3>Materials and Methods</h3><div>Our plesiotherapy workflow begins with thin-cut (1mm slice) CT simulation of the treatment area for patient setup and applicator fabrication. Depending on the site, immobilization methods may be used for patient comfort and position reproducibility. A 10 mm thick bolus structure is created from the simulation image set in treatment planning system software. Applicator channel paths are designed in Autodesk Inventor (Autodesk, Inc. San Francisco, CA). Two molds are then 3D printed for surface applicator casting: an external mold is printed with PLA on an Ultimaker S7 printer (Utrecht, Netherlands) to maintain the applicator shape; and internal molds are printed with regular resin using a FormLab Form 3 printer (Somerville, MA) to house the applicator channels. Once assembled, silicone (ECO-Flex 00-30, Smooth-on) was cast into the molds. After curing, single leader flexible implant tubes are inserted into the channels and fixed in place with standard plastic buttons. The patient undergoes a second CT simulation scan for treatment planning, during which the applicator location is marked on the patient for reproducibility on treatment days. Figure 1 illustrates a 3D rendering of a silicone applicator for a vulvar and perineal surface region treatment.</div></div><div><h3>Results</h3><div>HDR plesiotherapy using a patient-specific flexible applicator has been successfully implemented clinically. Several patient-specific applicators have been made to treat sites (e.g. vulvar, face, buttock) with surface contours that would be difficult to treat with external beam or standard flap-based HDR brachytherapy.</div></div><div><h3>Conclusions</h3><div>This approach demonstrates the feasibility and effectiveness of using a silicone surface applicator in delivering targeted radiation therapy for skin cancer treatment, offering a promising option for patients with lesions in challenging anatomical locations. Future work will evaluate the use of surface-guided imaging technologies to reduce the number of CT simulations. Also, optimization strategies for catheter trajectories will also be investigated.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527202","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":"BP07 Presentation Time: 4:54 PM","authors":"Robert Herrera BA ,&nbsp;Usha Abraham MSc ,&nbsp;Cristina Lopez-Penalver MD ,&nbsp;Alonso La Rosa MD ,&nbsp;Dustin Epstein BASc ,&nbsp;Marc Morcos PhD ,&nbsp;Jessika Contreras MD ,&nbsp;Vibha Chaswal PhD ,&nbsp;Maria-Amelia Rodrigues MD","doi":"10.1016/j.brachy.2024.08.031","DOIUrl":"10.1016/j.brachy.2024.08.031","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;As an alternative to the standard 4 to 6 weeks of breast-conserving surgery with whole breast irradiation, a two-day short course accelerated partial breast irradiation (APBI) is available proposed in Triumph-T trial. We present the 2-year follow-up results from a single institution of a 3-fraction APBI delivered using the Strut-Adjusted Volume Implant (SAVI) brachytherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;Retrospective analysis was conducted to evaluate the efficacy of an ultra-hypofractionated 2-day APBI schedule [22.5 Gy in 3 fractions, Bi-daily, ∼6 hours apart]. Women aged 40 years or older with early-stage breast cancer with diagnosis pTis or pT1-2 underwent breast-conserving surgery and received APBI using high-dose-rate Ir-192 SAVI-brachytherapy. The SAVI applicator is offered in four sizes, each designed to accommodate different cavity volumes: 6-1 mini, 6-1, 8-1, and 10-1. During follow-up (2019-2021), data was gathered on patient and tumor characteristics, treatment summary, oncologic outcomes, and both acute and late treatment-related toxicities, using the Common Terminology Criteria for Adverse Events (CTCAE) v5. Adverse events occurring within 90 days following the completion of APBI were defined as acute, whereas those thereafter were considered late.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 103 female patients (median age, 67 years [range (R), 40-92 years] mainly with pT1 tumors (77.7%) underwent APBI using SAVI-brachytherapy. Seventy-seven percent of the patient had invasive carcinoma histology and 22.3% were Ductal carcinoma in situ (DCIS). Median tumor size was 10 mm [R, 1.0-30.0 mm]. There were 91.3% estrogen positive and 84.5% progesterone receptors positive tumors, while Her2neu was positive in 1.9% of cases. Post-APBI, 88.3% of patients received adjuvant hormonal therapy and 7.8% received adjuvant chemotherapy. With a median follow-up of 36.4 months [R, 2.3-53.0 months], the most commonly reported toxicities were hyperpigmentation (47.6%) followed by skin induration (32.0%). Acute grade 1 toxicities were seen in 35.0% of cases, including 27.2% hyperpigmentation, 7.8% skin induration, 6.8% breast pain, 2.9% fatigue, 1.9% moist desquamation, and 1.0% erythema. Late grade 1 toxicities were seen in 53.4% of cases, including 28.2% skin induration, 24.3% hyperpigmentation, 17.5% breast pain, 4.9% fatigue, 1.9% telangiectasia, and 1.0% moist desquamation. No acute or late grade 2+ toxicities were observed. Fifteen patients developed late grade 1 fat necrosis within a median 17.3 months [R, 4.2-38.2 months], 12 were asymptomatic and 3 were symptomatic. Six patients developed breast tissue fibrosis. There were 2 (1.9%) local recurrences. Two-year overall survival following APBI was 98.1%.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Retrospective analysis of 2-year follow-up of 103 patients treated at our center using 3-fraction APBI with SAVI- brachytherapy, after breast-conserving surg","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527275","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":"BP09 Presentation Time: 5:12 PM","authors":"Adam Kluska MD PhD,&nbsp;Adam Chicheł MD PhD,&nbsp;Artur Chyrek MD PhD,&nbsp;Wojciech Burchardt MD PhD","doi":"10.1016/j.brachy.2024.08.033","DOIUrl":"10.1016/j.brachy.2024.08.033","url":null,"abstract":"<div><h3>Purpose</h3><div>Our prospective mono-institutional non-randomized open-label study (NTC05142202) evaluates the impact of adjuvant accelerated partial breast irradiation with HDR brachytherapy on health-related quality of life (QOL) of patients with low-risk early-stage breast cancer after breast-conserving surgery. It is to report an interim analysis of a novel fractionation scheme's influence on patients' QOL.</div></div><div><h3>Material and Methods</h3><div>147 patients were enrolled in a prospective study during recruitment between October 2021 and December 2023. Treatment was performed using postoperative interstitial HDR brachytherapy and was given for three days in 5 fractions of 5,4 Gy up to a total dose of 27,0 Gy. Health-related QOL was assessed using the QLQ-C30 questionnaire and breast cancer-specific HRQL module (EORTC QLQ-BR23) before APBI, one month, three months, six months after treatment, and every six months after that. Both questionnaires contain functional scales (a higher score represents better functioning) and symptom scales (a higher score represents a higher level of symptoms). This analysis presents a preliminary report of the short-term (6 months) QOL of 111 patients who completed six months of follow-up (FU). Repeated measures ANOVA was used to compare HRQL scores between time points. A p-value below 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>There was a statistically significant increase in the mean of social functioning scale (SF, Fig. 1A; <em>p=0.019</em>) and an increase in the constipation symptoms scale (CO, Fig. 1B; <em>p=0.004</em>) assessed in EORTC QLQ-C30 scale. The analysis of EORTC QLQ-BR23 module scales showed an increase in body image functional scale (BRBI, Fig. 1C, <em>p=0.004</em>) and future perspective functional scale (BRFU, Fig.1D; <em>p&lt;0.001</em>). In symptoms scales, there was an increase in the systemic therapy side effects scale (BRST, Fig. 1E; <em>p=0.001</em>) and a decrease in breast symptoms (BRBS, Fig. 1F; <em>p=0.006</em>). There were no other statistically significant changes in the functional or symptom scales of the QLQ-C30 and BR23 questionnaires.</div></div><div><h3>Conclusions</h3><div>There is no deterioration of short-time health-related quality of life of patients treated with 5 × 5,4 Gy HDR APBI. We observed increased symptoms only in scales linked with adjuvant systemic therapy. After six months of FU, an increase in body image functional scale and a decrease in breast symptoms after the treatment are worth noticing the most promising observations.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527277","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":"Thursday, July 11, 20244:00 PM - 5:30 PM BP01 Presentation Time: 4:00 PM","authors":"Vratislav Strnad Prof. MD ,&nbsp;Csaba Polgar Prof. MD ,&nbsp;Tibor Major PhD ,&nbsp;Jose Luis Guinot MD ,&nbsp;Cristina Gutierrez Miguelez MD ,&nbsp;Kristina Lössl PD, MD ,&nbsp;Bülent Polat PD, MD ,&nbsp;Peter Niehoff Prof. MD ,&nbsp;Christine Gall PhD ,&nbsp;Wolfgang Uter Prof. MD","doi":"10.1016/j.brachy.2024.08.025","DOIUrl":"10.1016/j.brachy.2024.08.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate efficacy results of the GEC-ESTRO phase 3 non-inferiority trial in subgroups of patients defined by the GEC-ESTRO and ASTRO patient selection criteria for APBI.</div></div><div><h3>Methods</h3><div>Patients aged ≥ 40 years with low risk invasive breast cancer or ductal carcinoma in-situ after breast conserving surgery were randomized to receive either 50 Gy WBI with tumor bed boost of 10 Gy or APBI using multicatheter brachytherapy. 633/1184 patients were randomized to APBI using multicatheter brachytherapy. In the context of the current available complete results after 10 years follow-up, we report results of a supplementary sub-analysis of these latter 633 patients regarding 10-year local control rates, disease-free and overall survival results comparing subgroups categorized according to the GEC-ESTRO and ASTRO patient selection criteria for APBI. Of note, some of these criteria qualifying patients as more than low risk or as cautionary, respectively, did not occur in our patient cohort by design (c.f. in-/exclusion criteria). The trial is registered with ClinicalTrials.gov, NCT00402519.</div></div><div><h3>Results</h3><div>The 10-year local recurrence rate in the APBI arm was 3.5% (95% CI: 2.0-5.0%). Among 633 patients treated with multicatheter brachytherapy for APBI, according to ASTRO criteria altogether 423 patients (66.8%) were classified as “suitable”, 195 (30.8%) as “cautionary” and 11 (1.7%) as “unsuitable”; in 4 cases no ASTRO categorization was possible. In the “suitable” and “cautionary” groups, the cumulative incidence (95% CI) of local recurrence at 10 years was 3.3% and 5.0% (p=0.61), respectively; difference 1.7% (95% CI: -2.0 to 5.5%). 10-year disease-free survival was 81.9% and 83.6% (p=0.63), respectively. According to GEC-ESTRO criteria, 430 patients (68%) were classified as good candidates for APBI - “low risk group”, 203 (32%) as possible candidates for APBI - “intermediate risk group”, with no patients being in the “high risk group”. Using ESTRO criteria for subgrouping of patients, the cumulative incidence of local recurrence at 10 years was 3.5% versus 4.4% (p = 0.55) in the “low risk group” and “intermediate risk group”, respectively; difference 0.9% (95%CI: -2.6 to 4.5%). Furthermore, 10-year disease-free survival was 81.0% versus 86.4% (p = 0.11) in the “low” and “intermediate” risk group, respectively.</div></div><div><h3>Conclusion</h3><div>The 10-year results in patients treated with breast conserving surgery followed by APBI using multicatheter brachytherapy are comparable as well between “low risk” and “intermediate risk” groups according to GEC-ESTRO criteria as between “suitable” and “cautionary” risk groups according to ASTRO criteria. Based on the present long-term results of APBI, refinement of available recommendations for APBI patient selection criteria should be discussed to allow more patients to be treated with APBI after breast conserving surgery.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526711","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":"Listing of the Abstracts of the 2024 American Brachytherapy Society Annual Meeting","authors":"","doi":"10.1016/j.brachy.2024.08.001","DOIUrl":"10.1016/j.brachy.2024.08.001","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526707","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":"PPP02 Presentation Time: 10:39 AM","authors":"Irini Youssef MD,&nbsp;Rahul Barve MD,&nbsp;Victoria Brennan MD,&nbsp;Daniel Gorovets MD,&nbsp;Daniel Shasha MD,&nbsp;Sankalp Pandya BSc, MRes,&nbsp;Joel Beaudry MS,&nbsp;Antonio Damato PhD,&nbsp;Marisa Kollmeier MD","doi":"10.1016/j.brachy.2024.08.094","DOIUrl":"10.1016/j.brachy.2024.08.094","url":null,"abstract":"<div><h3>Purpose</h3><div>Erectile function is a significant quality of life consideration for patients electing definitive radiation therapy. We compared erectile outcomes following low dose rate (LDR) relative to stereotactic body radiation therapy (SBRT) as monotherapy for patients with localized prostate cancer.</div></div><div><h3>Methods/Materials</h3><div>Using a prospectively collected institutional database, we retrospectively analyzed the charts of patients who underwent LDR (I-125; 144Gy or Pd-103; 125Gy) brachytherapy or SBRT as monotherapy for prostate cancer and were potent (IIEF-5&gt;20) at baseline. Patient-reported erectile function was measured at baseline at each post-treatment followup using IIEF-5 (International Index of Erectile Function). The use of erectile medications was also collected at each timepoint. Clinical (smoking history (none vs former/current), hypertension(yes/no) diabetes (yes/no) and dosimetric parameters were also collected.</div></div><div><h3>Results</h3><div>The study cohort included 112 patients undergoing LDR and 171 patients undergoing SBRT with a median followup of 31 months for both cohorts. Mean D90% for brachytherapy patients was 111.4%. Median SBRT dose was 4000 (range 3750-4500). 92% of patients received 4000 cGy. Mean age for SBRT patients is 66.7 years (SD±6.8) and 60.5 (SD±71) for brachytherapy patients (p&lt;.001). There were no significant difference in smoking status (p=0.317), hypertension (p= 43) or diabetes (p= 0.18) between cohorts. There was no difference between cohorts with respect to mean baseline IIEF (27; range (21-30) (p=0.8). Mean IIEF at 12 mo ±3 was 20.6 for SBRT group versus 24.1 for brachytherapy group (P=.007). At 18 mo±3 mo, it was 20.35 for SBRT group versus 23.28 for brachytherapy group (P=.03). At 24 mo±3mo, it was 20.2 for the SBRT group versus 25.9 for the brachytherapy group (P&lt;.001). 63% (N=107) versus 72% (N=79) patients in the SBRT and brachytherapy group, respectively, were on ED medications following treatment (P=.07).</div></div><div><h3>Conclusion</h3><div>Overall erectile preservation with IIEF &gt;20 is high with both LDR and SBRT monotherapy. Higher mean IIEF scores were noted at multiple timepoints for LDR compared with SBRT. Further analyses are needed to assess whether these differences are clinically meaningful.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527281","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":"MSOR02 Presentation Time: 8:05 AM","authors":"Anne Valkenburg MD ,&nbsp;Evert van Limbergen MD, PhD ,&nbsp;Maaike Berbée MD, PhD ,&nbsp;Mark Long MSc ,&nbsp;Nikolaos Tselis MD, PhD ,&nbsp;Alexandra Stewart MD, PhD","doi":"10.1016/j.brachy.2024.08.065","DOIUrl":"10.1016/j.brachy.2024.08.065","url":null,"abstract":"<div><h3>Purpose</h3><div>Earlier it was demonstrated that lack of standardization in dose reporting is hampering progress in the field of rectal brachytherapy (Verrijssen et al 2019). Standardization of dose reporting and thus treatment data would allow for better comparison of results between patient cohorts of different studies and also allow for NTCP or TCP modelling. A prerequisite for standardized dose reporting is standardization of target volume and organ at risk (OAR) delineation. As there is currently a lack of guidelines for target volume definition and organ at risk delineation in image-guided rectal HDR brachytherapy, this project is aimed at solving this issue. The collaboration involves members of GEC ESTRO and the ABS.</div></div><div><h3>Materials and Methods</h3><div>The target volume consensus process consists of several steps: Step 1: Selection of an expert group and evaluation group (including radiation oncologists and physicists from Europe/Canada/India). Step 2: Survey regarding target volume delineation in each institution. Step 3: Delineation of 3 rectal cancer (RC) cases with different clinical stages using the FALCON platform. Step 4: First expert group meeting to create a draft guideline. Step 5: Redelineation by the expert group using the draft guideline. Step 6: Second expert group meeting to evaluate the redelineations and optimize the draft guideline. Step 7: Redelineation by the evaluation group and finalization of the guideline.</div></div><div><h3>Results</h3><div>The current project involves radiation oncologists and physicists from 10 countries in Europe/Canada/India and has currently finalized step 2. Ten out of 17 respondents indicated that they don't have their own delineation guidelines. There is clear variation in the CTV definitions used, for example some use margins and some prescribe to the GTV. Eleven respondents don't use PTV margins. There is no consensus on which OAR need to be delineated and how.</div></div><div><h3>Conclusions</h3><div>Our survey has shown that target volume delineation and OAR definition varies widely between institutions. Here we describe the methodology to come to international standardization in dose reporting for rectal brachytherapy. The next step is to evaluate the consensus and differences in target and OAR delineation between the different centers using test cases, prior to contouring guideline development.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526894","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}