Brachytherapy最新文献

{"title":"The NorCal brachytherapy waste audit: A simple, validated, toolkit for clinician led waste reduction.","authors":"Claire C Baniel, Katie E Lichter, Melissa A Frick, Jaclyn Wu, Eniola Oladipo, Yufan Fred Wu, Aneesh SwamyS, I-Chow Hsu, Nicolas Prionas, Erik S Blomain, Elizabeth A Kidd, Mark K Buyyounouski, Glenn Rosenbluth, Osama Mohamad, Hilary P Bagshaw","doi":"10.1016/j.brachy.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.brachy.2025.01.002","url":null,"abstract":"<p><strong>Purpose: </strong>The healthcare system is resource intensive, and many opportunities exist to reduce medical waste. Brachytherapists performing inherently resource intensive procedures are well poised to initiate the transition to sustainable, climate-smart care. The authors developed a quality improvement-based (QI) NorCal Brachytherapy Waste Audit Toolkit to guide medical waste reduction in brachytherapy procedures and provide climate health education.</p><p><strong>Methods and materials: </strong>The NorCal Brachytherapy Waste Audit Toolkit was validated through brachytherapy waste audits conducted at 2 neighboring hospitals between 2021 and 2023. Waste was categorized into biohazardous waste, nonbiohazardous waste, and anesthesia waste and was weighed and cataloged after each procedure using a standard template by auditors not involved in the brachytherapy case. Findings were analyzed for key drivers of waste production and high impact interventions were selected.</p><p><strong>Results: </strong>Postaudit results demonstrate biohazardous waste reduction of greater than 50%, elimination of over 90% improper biohazardous waste sorting, cost savings ($4.22/kg) and a reduction in landfill waste by over 20%. The Toolkit was made public online and over 18 months, was accessed by 34 distinct individuals from 21 healthcare organizations across 7 countries and led to waste reduction projects in multiple specialties including radiation oncology, emergency medicine, and pediatrics.</p><p><strong>Conclusion: </strong>A QI-based NorCal Brachytherapy Waste Audit Toolkit may help radiation oncologists and healthcare teams beyond radiation oncology reduce waste and contribute toward environmentally sustainable healthcare.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prostate Posters PO51","authors":"Nahuel Eduardo Paesano, Nuria Jornet i Sala, Jadi Rojas Cordero, Nahuel Paesano, Alicia Maccagno, Gilberto Chechile Toniolo","doi":"10.1016/j.brachy.2023.06.152","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.152","url":null,"abstract":"Purpose Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy. To evaluate oncological outcomes and genitourinary and gastrointestinal adverse events in patients treated with real-time low dose rate (LDR) Iodine-125 BT as a treatment for localized prostate cancer. Materials and Methods To carry out this study, all patients treated with BT in monotherapy with or without associated androgen deprivation therapy for the treatment of localized PCa were prospectively included from June 2003 to August 2021. Strict post-treatment follow-up was performed. was performed every 6 months. Reviews include quality of life (QoL) test, assessment of urinary obstructive symptoms using IPSS (International Prostate Examples Score), SHIM (Sexual Health Inventory for Men), IIEF-15 questionnaires to assess sexual quality, specific total stretching prostate (PSA), ultrasound and flowmetry. The statistical method used was the Kaplan Meier and Cox regression with the SPSS computer system. Results A total of 445 patients were evaluated. The mean age at which the BT was performed was 65.3 years (SD=7.7). The mean prostate volume was 41.0 cm3. (SD=14.3). The mean PSA before BT was 7.28 (SD= 4.33). Regarding the D'Amico risk classification, 48.3% (215/445) of the patients were low risk, 45.1% (201/445) intermediate risk, and 6.6% (29/445). 445) high risk. 22.5% (100/445) received associated hormonal therapy. 47.8% (213/445) of the patients presented urological complications after CT, with urinary frequency being the most frequent. Rectal complications manifested in 17.7% (78/445) of the patients and the most frequent was tenesmus. The main urinary complication was urinary frequency, which was significantly associated between the first 3 months and the year after CT. After one year, most patients had the same micturition quality as before BT. The mean follow-up is 6 years, showing an overall biochemical recurrence-free survival (BLFS) of 92.3% (411/445). Regarding biochemical recurrence according to risk group, 14 patients with treatment failure were low risk, 15 intermediate risk and 5 high risk. No statistically significant association was found between risk stratification and recurrence. However, for the group of patients considered to be at high risk, the percentage of recurrence was higher. Conclusions BT offers excellent oncological control in the treatment of low and intermediate risk prostate cancer with acceptable rates of adverse events. Since 1983, Brachytherapy (BT) has been used for the treatment of localized prostate cancer (CaP). Over the years, this technique has been consolidated, updated and perfected as a curative treatment for low-risk PCa, and its indication has been extended to intermediate-risk cancer as monotherapy","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO126","authors":"Ron Digiaimo","doi":"10.1016/j.brachy.2023.06.226","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.226","url":null,"abstract":"This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers. This session will review common Brachytherapy Coding and Documentation opportunities and risks. The information provided will help the provider and the institution know the appropriate coding for compliant submission to payers as well as reasons for denial of payment. For example Prostate and Breast HDR, Skin HDR, Prostate LDR may be reviewed with associated coding and documentation requirements. Brachytherapy generally requires insurance authorization and may be a cause of denial of payment if not done properly or timely. In addition financial counseling can contribute material benefits to both the provider and institution as well as create psychological benefit to the patient. Examples of coding and denials will be provided along with suggestions on how to deal with appeals for payments from both government and commercial payers.","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO67","authors":"Tyler E. Gutschenritter, Anthony Pham, Homayon Parsai, Joe Bradlo, Merriah Montague, Sarah Reith, Justin Bell, Rosanna Mangibin, Richard Alex Hsi","doi":"10.1016/j.brachy.2023.06.168","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.168","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO38","authors":"Bethel Adefres, Christopher Jason Tien, Shari Damast","doi":"10.1016/j.brachy.2023.06.139","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.139","url":null,"abstract":"Purpose Adjuvant vaginal cuff brachytherapy (VCB) for endometrial cancer (EC) is typically delivered with single-channel vaginal cylinders with diameters ranging from 2.0 to 4.0 cm. Due to the unfavorable dosimetry of 2.0 cm diameter cylinders, larger diameter cylinders are used whenever possible. There are, however, occasional patients with narrow vaginal anatomy for whom only a 2.0 cm cylinder can be accommodated. In this unique population, in addition to the dosimetric challenges for a typical prescription to 5 mm depth (ie., heterogeneity of about 170% and 210% of prescription dose at the surface of the cylinder lateral walls and tip, respectively), there tend to be clinical challenges as well such as insertional pain or difficulty with procedural tolerance. This study reports the clinical outcomes of an EC cohort that received VCB with cylinder size 2.0 cm at a single institution. Materials and Methods From an IRB-approved institutional database of EC patients treated with VCB between 07/01/2014-11/30/2022, all patients that were fitted with 2.0 cm cylinder were retrospectively reviewed. Although our institutional prescriptions for cylinders larger than 2.0cm are at 5mm depth (6-7 Gy x 3 fractions weekly), for the 2.0cm cylinder patients, VCB prescriptions are to the vaginal surface (10Gy x 3 fractions weekly), to avoid issues resulting in unacceptably high surface dose. Patient demographics, disease and treatment characteristics, recurrence rates and complications were descriptively analyzed. Toxicity was recorded via the CTCAE v4.0. The Kaplan-Meier method was used to assess freedom from vaginal recurrence. All computations were performed in IBM SPSS Statistics 28. Results Among 655 consecutive EC patients treated with VCB, there were 36 women (5%) that were treated with cylinder size 2.0 cm. Median age was 68.5 years (range: 46-95 years). The majority were nulliparous (77.8%) and 15 women (42%) had documented baseline pain or anxiety related to pelvic examination prior to VCB. Median BMI was 39 (range: 19-62). Baseline vaginal length was 8.3cm (range: 5-14cm). 78% had stage I-II, 14% had stage IIIA, and 8% had stage IVB EC. The histological subtypes included endometrioid adenocarcinoma (69%), mixed (11%), serous (8%), clear cell (6%) and de-differentiated (6%). 42% of the patients received chemotherapy. None received external beam radiotherapy. Median interval from surgery to VCB was 54 days (range: 43-119 days). All received 10Gy x 3 fractions prescribed to vaginal surface, and active length was 3cm (5.6%), 4cm (63.9%) or 5cm (30.6%). 3D planning was performed in 58% of the cohort, while 2D planning was used in the remainder due to issues related to body habitus and/or poor mobility. Median follow-up was 17.5 months (range: 3-76 months). The 2-year freedom from vaginal recurrence was 96%. There was only 1 vaginal recurrence, which was out of field. 5 patients died from disease, unrelated to radiation treatment. There were no grade 2 or h","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO42","authors":"Ria Mulherkar, Hong Wang, Mark Jelenik, Hayeon Kim, Christopher J. Houser, Elangovan Doraisamy, Madeleine Courtney-Brooks, Alexander Olawaiye, John Comerci, Michelle Boisen, Jessica Berger, Joseph Kelley, Paniti Sukumvanich, Sarah Taylor, Robert Edwards, Lan Coffman, Ronald Buckanovich, Jamie Lesnock, Haider Mahdi, Shannon Rush, John Austin Vargo, Sushil Beriwal, Parul Barry","doi":"10.1016/j.brachy.2023.06.143","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.143","url":null,"abstract":"Disparities in race and socioeconomic factors affect patient access to cancer screening, treatment, and clinical outcomes. The aim of this project was to evaluate relationship between race and socioeconomic factors including insurance status, employment status, disability status, and distance from brachytherapy center on clinical outcomes including stage at presentation, number of nodes positive, brachytherapy technique, progression-free survival (PFS), and overall survival (OS). All cervical cancer patients treated with brachytherapy at our institution from 2007-2017 were identified. Race and socioeconomic factors including insurance status, employment status, disability status, and distance from brachytherapy center were recorded. Clinical characteristics including stage at presentation, number of involved nodes, and brachytherapy technique were also recorded. PFS and OS were calculated from date of last brachytherapy fraction, with censorship at date of last follow-up. Correlation was tested between racial and socioeconomic factors and survival outcomes (i.e., PFS and OS) using Cox regression models. Their association with other outcomes was examined with Wilcoxon rank sum tests, Fisher's exact tests, and Spearman's rank correlation coefficients where appropriate. 251 cervical cancer patients were identified, with median follow-up 5.2 years (IQR 2.0-7.7 years). On univariate analysis (UVA), there was no correlation between brachytherapy technique utilized, number of nodes positive, or stage at presentation and race, distance from treatment center, insurance status, employment status, or disability status. UVA did show a significant correlation between PFS and race, insurance status, employment status, and disability status. Significantly worse PFS was seen in non-white group (p=0.036), uninsured group (p<0.001), unemployed group (p<0.001), and disabled group (p=0.041). Similarly, there was significant correlation between OS and race, insurance status, employment status, and disability status. Significantly worse OS was seen in non-white group (p=0.005), uninsured group (p<0.001), unemployed group (p<0.001), and disabled group (p=0.008). On multivariate analysis (MVA), there was no significant correlation between race or disability status and PFS, but there was significantly improved PFS seen in patients with insurance (p < 0.001) and patients who were employed (p = 0.002). MVA showed no correlation between disability status and OS, but significantly worse OS in patients who were non-white (p=0.039) and significantly improved OS in patients with insurance (p<0.001), and patients who were employed (p-0.001). MVA showed no significant correlation between stage and insurance or employment status. MVA showed no significant correlation between histology and employment status; on MVA patients with government insurance were less likely to have squamous histology compared with no insurance (p=0.002). Insurance and employment status are significant pred","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO121","authors":"Hari Menon, Charles R. Wallace, Jessica M. Schuster, Kristin A. Bradley, Bethany M. Anderson","doi":"10.1016/j.brachy.2023.06.222","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.222","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO34","authors":"Devin Van Elburg, Sarah Quirk, Kevin Martell, Tyler Meyer, Michael Roumeliotis","doi":"10.1016/j.brachy.2023.06.135","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.135","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO61","authors":"Fada Guan, Emily Draeger, David Carlson, Zhe Chen, Christopher Tien","doi":"10.1016/j.brachy.2023.06.162","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.162","url":null,"abstract":"Purpose In the conventional fractionation schemes of high-dose-rate (HDR) brachytherapy, the intra-fractional and inter-fractional DNA damage repair and repopulation of tumor cells are neglected in calculating the biologically effective dose (BED). This may result in inaccurate model prediction of the theoretical tumor control probability (TCP). Notwithstanding, current prostate brachytherapy prescriptions may still be large enough to theoretically overcome these effects, among others. The purpose of this study was to recalculate the theoretical TCP, accounting for intrafraction DNA damage repair and 192Ir source decay for prostate cancer treated using HDR brachytherapy as the monotherapy, compared against common 1-, 2-, and 9-fraction prescription schemes. Materials and Methods We incorporated the Lea-Catcheside dose protraction factor g, the effective tumor doubling time Td, the total elapsed time of the treatment course T, and the onset or lag time of cell repopulation Tk, into the full-form BED calculation, in contrast to the simple form BED which only includes the total dose, dose per fraction and α/β. The Poisson model relating the surviving fraction and the number of tumor clonogens (K) was used to calculate TCP. The parameter set α = 0.15 Gy-1, α/β = 3.1 Gy, τ = 0.27 h (DNA damage repair half time), Td = 42 days, and Tk = 0 was used for the full-form BED calculation. K = 1.1 × 107 from the high-risk group was used in the TCP calculation. The new 192Ir source (40,700 U, 10 Ci, 1.27 Gy/min) and the 90-day source (17,470 U, 4.3 Ci, 0.55 Gy/min) were used to investigate the source decay effect on TCP. Three different fractionation schemes n = 1, 2, and 9 fraction(s) were studied. Simple BED, full-form BED (both 10 Ci and 4.3 Ci), TCP50 (total dose at TCP = 50%), and TCP90 (total dose at TCP = 90%) were calculated for each setup. 1 x 21 Gy, 2 x 13.5 Gy, and 9 x 6 Gy prescriptions were selected to evaluate the robustness of different fractionation schemes on TCP impacted by DNA damage repair and source decay. Results TCP50 and TCP90 using the simple BED, the full-form BED at 10 Ci and 4.3 Ci were calculated. In the single-fraction group, TCP50 = 17.0, 18.6, and 21.2 Gy, and TCP90 = 18.0, 19.9, and 22.8 Gy. In the 2-fraction group, TCP50 = 23.3, 24.7, and 26.8 Gy, and TCP90 = 24.7, 26.3, and 28.7 Gy. In the 9-fraction group, TCP50 = 43.3, 44.3, and 45.6 Gy, and TCP90 = 46.3, 47.4, and 48.9 Gy. For 1 × 21 Gy, the simple BED and full-form BED (10 Ci and 4.3 Ci) = 163.3, 134.8, and 109.0 Gy, and TCP = 99.9%, 98.2%, and 41.9%. For 2 × 13.5 Gy, the simple BED and full-from BED (10 Ci and 4.3 Ci) = 144.6, 128.5, and 112.0 Gy, and TCP = 99.6%, 95.4%, and 57.4%. For 9 × 6 Gy, the simple BED and full-from BED (10 Ci and 4.3 Ci) = 158.5, 151.4, and 143.4 Gy, and TCP = 99.9%, 99.9%, and 99.5%. In general, we have observed: (1) using the simple BED overestimated the TCP compared to the full-form BED, (2) with the source decay, a higher total dose was needed","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO59","authors":"Jiheon Song, Mark Corkum, Andrew Loblaw, Hans Tse-Kan Chung, Chia-Lin Tseng, Patrick Cheung, Ewa Szumacher, Stanley Liu, William Chu, Melanie Davidson, Matt Wronski, Liying Zhang, Alexandre Mamedov, Gerard Morton","doi":"10.1016/j.brachy.2023.06.160","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.160","url":null,"abstract":"Purpose High dose-rate (HDR) brachytherapy as monotherapy is an effective treatment for patients with low- and intermediate-risk prostate cancer and is increasingly being offered as a 2-fraction protocol. There is a lack of consensus on the optimal dosimetric planning parameters to use, or whether there is any benefit summating dosimetric parameters from more than one implant. Our goal is to determine planning parameters associated with disease control, toxicity and health-related quality of life (HRQOL). Materials and Methods Data were collected on 83 patients with low- and intermediate-risk prostate cancer who received 2 fractions of 13.5 Gy HDR brachytherapy without androgen-deprivation therapy or external beam radiotherapy as part of a randomized phase II clinical trial. An in-house deformable, registration algorithm was used to co-register and dose-summate the plans from both for each patient. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities were measured using Common Toxicity Criteria for Adverse Events (CTCAE) 4.0 and HRQOL was measured in urinary, bowel, sexual and hormonal domains using the expanded prostate cancer index composite (EPIC) scores. Treatment efficacy was assessed through PSA measurement and imaging with or without biopsy where indicated. Covariates included baseline clinical factors, disease characteristics and treatment dosimetric parameters. Cox proportional hazards was performed to evaluate covariates impact on treatment toxicity and efficacy, and logistic regression analysis evaluated covariates impact on HRQOL. Results Among the 83 patients, median prostate volume was 46.7cm3. Median summated planning target volume receiving 100% prescription dose (PTV V100%) was 97.4%, median PTV V150% 42.4% and median PTV V200% 15.5%. Median highest dose to the 1cm3 rectum (D1cc) was 66.9% of the prescription dose and median rectum V80% was 0.008cm3. Median urethral D1cc was 99.0% of the prescription dose, median urethral Dmax 121.7% and median urethral D10% 116.2%. Grade ≥2 GI toxicity was uncommon (3.7% acute and 8.5% late), but grade ≥2 GU toxicity was reported in 73.2% (acute) and 46.3% (late) patients. Rectum D1cc and V80% were found to be significantly associated with grade 2 or higher acute GI toxicity, while use of α-blocker at baseline was associated with grade ≥2 acute GU toxicity. Similarly, higher percentage of Gleason 4 disease and use of α-blocker were associated with late grade ≥2 GU toxicity. No other variables were associated with treatment-related toxicities. Only rectum D1cc was significantly associated with changes in bowel EPIC scores. Dosimetric parameters did not predict disease recurrence. Estimated 5-year biochemical disease-free survival was 93.9% and 5-year cumulative incidence of local failure was 3.8%. Conclusions HDR monotherapy with 27 Gy delivered in 2 fractions in treatment of prostate cancer is well tolerated with high rates of disease control and minimal toxicity. Dose summatio","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}