Brachytherapy最新文献

{"title":"Salvage interstitial brachytherapy for treatment of recurrent endometrial cancers in the vagina: Seven-year single institution experience and review of second recurrence patterns.","authors":"Marissa Sherwood, Toni Barnes, Hanbo Chen, Amandeep Taggar, Moti Paudel, Liying Zhang, Aishah Alqaderi, Eric Leung","doi":"10.1016/j.brachy.2024.09.007","DOIUrl":"10.1016/j.brachy.2024.09.007","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial brachytherapy (ISBT) is a known treatment for vaginal recurrence of endometrial cancer. This study reviews a large tertiary institution's ISBT experience and outcomes for vaginal recurrences.</p><p><strong>Material and methods: </strong>Patients who underwent salvage ISBT for vaginal recurrence of endometrial cancer from January 1, 2014 to August 31, 2021, were identified. Initial and salvage disease factors and treatments were recorded. Outcomes were calculated including overall survival, local, and distant failure.</p><p><strong>Results: </strong>Thirty-nine patients were included; thirty received external beam radiotherapy and interstitial brachytherapy (EBRT + ISBT) while 9 received ISBT alone. At initial diagnosis, the ISBT alone group had an older median age, with stage IA-IV disease, frequently receiving adjuvant treatment, compared to the EBRT with ISBT group with mainly stage IA disease who did not. Median follow up was 22 months and median time to recurrence 14 months (16.5 months in EBRT + ISBT group and 14 in the ISBT alone group). Two-year overall survival was 85% for all patients, 85.6% and 83.3%in the EBRT + ISBT and ISBT alone groups, respectively. Local failure was 22.7% for all patients, 16.7% in the EBRT + ISBT group and 11.1% in the ISBT alone group. Median HRCTV D90 (EQD2) was 76.8 Gy in the EBRT + ISBT group, and 57.9 Gy in the ISBT alone group. Late grade 3 or higher toxicity occurred in only 3 patients.</p><p><strong>Conclusions: </strong>EBRT + ISBT is an effective treatment for endometrial cancer vaginal recurrence, with acceptable toxicity. ISBT alone is an option for patients with contraindications to or with previous treatment of pelvic radiation.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"36-44"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142483036","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":"Long-term disease-free survival and health-related quality of life results of high-dose-rate brachytherapy as monotherapy for low and intermediate-risk prostate cancer treated in a community cancer center.","authors":"Raphael William, Pierre-Yves McLaughlin, Mathieu Pharand-Charbonneau, Debbie Smith Wright, Alain Haddad, Marc Gaudet","doi":"10.1016/j.brachy.2024.10.004","DOIUrl":"10.1016/j.brachy.2024.10.004","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the long-term disease-free survival, long-term toxicity, and effect on health-related quality of life of a two-fraction regimen of high-dose-rate (HDR) prostate brachytherapy.</p><p><strong>Methods and materials: </strong>Patients with low- or intermediate-risk prostate cancer were treated with CT-planned HDR brachytherapy as monotherapy in two implants of 13.5 Gy in one community cancer center. Prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS) and Expanded Prostate Index Composite (EPIC) questionnaires were evaluated at each follow-up visit. Biochemical recurrence (Phoenix definition) was evaluated to determine disease-free survival at 5 and 7 years. Proportion of patients in each IPSS category (mild = 0-7, moderate = 8-18, severe = 19+) was evaluated at each follow-up interval.</p><p><strong>Results: </strong>Thirty patients were accrued to the study between 2014 and 2016. Median prostate-specific antigen was 8,7 (range 4.1-17.5). T stages were T1c = 65%, T2a = 21%, and T2b = 14%. Twenty-seven percent of patients had a Gleason score of 6 and 73% had a Gleason score of 7. 13% were in low risk category and 87% in intermediate risk category. Median follow-up was 84 months. There were no deaths at 84 months after brachytherapy. Disease-free survival was 90% at 5 years and 86% at 7 years. Two patients experienced late Grade 3 GU toxicity (6.6%).</p><p><strong>Conclusions: </strong>This study serves as proof of concept that HDR monotherapy can be performed successfully with excellent long-term outcomes in a community cancer center with adequate training and experience. The long-term disease-free survival rate and the health-related quality of life seem acceptable as compared to other treatment modalities. Further study is ongoing with regard to the optimal dosing regimen for HDR monotherapy.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"54-61"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640453","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":"Biochemical outcome of prostate cancer patients treated with hypofractionated external radiation and a single high-dose-rate brachytherapy boost.","authors":"Johan Staby Olsén, Antonios Valachis, Leif Karlsson PhLic, Bengt Johansson","doi":"10.1016/j.brachy.2024.07.005","DOIUrl":"10.1016/j.brachy.2024.07.005","url":null,"abstract":"<p><strong>Introduction: </strong>Treating localized high-risk prostate cancer with a combination of external beam radiation therapy (EBRT) and high-dose-rate brachytherapy (HDR-BT) is a common approach. Moderately hypofractionated EBRT and a single HDR-BT boost simplifies the treatment. We aim to present our five-year results.</p><p><strong>Methods: </strong>In this study, 355 patients treated with moderately hypofractionated EBRT (42 Gy in 14 fractions) and a single HDR-BT boost (14.5 Gy) at Örebro University Hospital between 2008 and 2018 were included. They were followed with regular PSA tests.</p><p><strong>Results: </strong>The median age of the cohort was 70 years (range: 51-81) and the median follow-up duration was 56 months (range: 6-150). Among them, 45% were classified as very high-risk, 38% as high-risk and 17% as intermediate-risk. Adjuvant androgen deprivation therapy (ADT) with a median duration of 24 months was given to 75% of the patient cohort. The estimated 5-year failure free survival rates were 79% (whole cohort), 66% (very high-risk), 90% (high-risk) and 85% (intermediate-risk), respectively. Initial PSA > 10 ng/mL, Gleason score 9-10 and tumor stage T3 were significantly associated with biochemical failure (BF). A PSA bounce occurred in 53 (15%) cases and was inversely associated with BF (p = 0.001) for patients receiving ADT.</p><p><strong>Conclusions: </strong>Moderately hypofractionated EBRT and a single HDR-BT boost seems to be an effective treatment against intermediate- and high-risk localized prostate cancer. Treatment escalation strategies should be investigated for very high-risk patients where the risk of recurrence remains high.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693934","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":"Escalating the dose of high-dose-rate brachytherapy combined with external beam radiotherapy improves the disease control rate in patients with high- or very-high-risk prostate cancer.","authors":"Takaya Inagaki, Yasutaka Noda, Yuya Iwahashi, Takahiro Naka, Maria Kojima, Riki Inagaki, Ryuki Shimono, Azusa Awaya, Yasuo Kohjimoto, Isao Hara, Tetsuo Sonomura","doi":"10.1016/j.brachy.2024.10.011","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.10.011","url":null,"abstract":"<p><strong>Purpose: </strong>High-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) is an effective treatment for patients with high- and very-high-risk prostate cancer. We sought to identify the factors associated with reduced biochemical recurrence rates following HDR-BT.</p><p><strong>Methods: </strong>A total of 304 patients with high- or very-high-risk prostate cancer who underwent HDR-BT and EBRT were analyzed. EBRT comprised 50 Gy in 25 fractions and HDR-BT comprised 18 Gy in 2 fractions. Biochemical recurrence was defined as an increase in prostate specific antigen (PSA) by ≥2.0 ng/mL from the nadir level.</p><p><strong>Results: </strong>The median follow-up time was 8.2 years (range, 3.4‒13.7 years) after HDR-BT. The 5-year biochemical progression-free survival (bPFS), overall survival, and cause-specific survival rates were 87.4%, 93.3%, and 100%, respectively. In univariate and multivariable analyses, a biologically effective dose (α/β = 1.5) ≥ 240 Gy and androgen deprivation therapy (ADT) were significantly associated with better bPFS (p = 0.020 and 0.007, respectively), whereas pretreatment PSA ≥ 40 ng/mL and Gleason score group 5 were significantly associated with worse bPFS (p = 0.080 and 0.021, respectively). Grade ≥ 3 rectal toxicities occurred in 0.3% of patients and grade ≥ 3 urinary toxicities occurred in 3.4% of patients.</p><p><strong>Conclusion: </strong>In patients with high- and very-high-risk prostate cancer treated with EBRT and HDR-BT, dose escalation and ADT were associated with improved tumor control. By comparison, Gleason score group 5 and pretreatment PSA >40 ng/mL were associated with worse tumor control.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916566","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":"3D-printed template assisted intracavitary/interstitial brachytherapy for cervical cancer using repeat FMEA: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1016/j.brachy.2024.10.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.10.001","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142904314","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":"Development and implementation of a 3d-HDR brachytherapy program for cervical cancer in a sub-Saharan African centre.","authors":"Adedayo Joseph, Onyinye Balogun, Bolanle Adegboyega, Omolola Salako, Omoruyi Credit Irabor, Azeezat Ajose, Samuel Adeneye, Adewumi Alabi, Ephraim Ohazurike, Chibuzor F Ogamba, Aishat Oladipo, Olufunmilayo Fagbemide, Muhammad Habeebu, David Puthoff, Adedayo Onitilo, Wilfred Ngwa, Chika Nwachukwu","doi":"10.1016/j.brachy.2024.10.002","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>Cervical cancer is the second most common cancer among women in Nigeria where, the gap between need for, and access to, radiation therapy including brachytherapy is significant. This report documents the implementation of the first three-dimensional high-dose-rate (3D-HDR) brachytherapy service for cervical cancer in Nigeria.</p><p><strong>Purpose: </strong>This report details the steps taken to implement the 3D-HDR brachytherapy program, the challenges faced, and the adaptive strategies employed to overcome them. Our objective is to provide a guide for teams and centers in similar resource-restricted settings to implement 3D-HDR brachytherapy services, by leveraging our shared experience and lessons learned.</p><p><strong>Method and meterials: </strong>The implementation process required investment in infrastructure: creating a dedicated brachytherapy suite equipped with modern technology; and human capital: conducting both virtual and hands-on training for staff; and involving international experts during the initial treatment phases. Quality assurance protocols were established to ensure the accuracy and safety of treatments. Key adaptations included extensive remote training, international experts flying in for the initiation phase, and preemptively re-ordering the radioisotope to prevent delays.</p><p><strong>Results: </strong>The 3D-HDR brachytherapy program was successfully implemented, with five cases treated in the first 2 months despite challenges such as high equipment costs, expertise and proficiency needs, and source replacement delays. Continuous training and quality assurance measures ensured the program's sustainability and effectiveness.</p><p><strong>Conclusions: </strong>Implementing a 3D-HDR brachytherapy program in a system with restricted resources is possible with thorough planning, flexible strategies, and adaptive measures. We document our experience to provide insights for other institutions aiming to establish similar programs. Collaboration and innovative financial strategies are essential for ensuring sustainable access to cancer treatment in the region. Strategies such as remote training and proactive resource management, are critical for overcoming implementation barriers.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901206","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":"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, Mwingereza J Kumwenda, Khamis O Amour, Jofrey J Masana","doi":"10.1016/j.brachy.2024.10.016","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.10.016","url":null,"abstract":"<p><strong>Background and purpose: </strong>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.</p><p><strong>Materials and method: </strong>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.</p><p><strong>Results: </strong>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 (D_Max) to D_ICRU for both organs being 1.15.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901130","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":"Postoperative high-dose-rate brachytherapy alone in stage T1-3N0M0 oral cancer with negative prognostic factors: A retrospective study.","authors":"Luboš Tuček, Igor Sirák, Denisa Pohanková, Linda Kašaová, Jakub Grepl, Petr Paluska, Miroslav Hodek, Milan Vošmik, Banni Aml Mustafa, Eva Čermánková, Jiří Petera","doi":"10.1016/j.brachy.2024.03.001","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.03.001","url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Methods and materials: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901215","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":"Transition from point A to volume based image guided brachytherapy across a network of centers in India through workshop and mentoring.","authors":"Harjot Kaur Bajwa, Manikumar Singamsetty, Mohan Lal, Manjinder Singh Sidhu, Sumeet Aggarwal, Ritu Agarwal, Midhun Murali, Dhanya K S, Rajesh Natte, Suresh Chaudhari, Vibhor Gupta, Sushil Beriwal","doi":"10.1016/j.brachy.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.005","url":null,"abstract":"<p><strong>Aim: </strong>To demonstrate how workshop and mentoring across a network of radiotherapy centers helped in transitioning from point A to volume-based image guided brachytherapy in carcinoma cervix.</p><p><strong>Materials and methods: </strong>Based on discussion with different centers across the network, the lapses in cervical cancer treatment were identified and a workshop was designed to change the practice pattern. The main focus of the workshop was to streamline EBRT dose prescription protocols and implement volume based image guided brachytherapy through mentoring and hands on training. Patient data was analyzed 1 year post workshop to assess the impact in changing practice pattern.</p><p><strong>Results: </strong>A total of 246 cervical cancer patients treated with radical chemo radiotherapy and image guided brachytherapy were analyzed. 207 patients received CT based intracavitary brachytherapy whereas 39 patients received MR based hybrid brachytherapy. In patients who received EBRT and brachytherapy at the same center, the EBRT prescription dose was 45Gy in 25 fractions in 95% patients. The mean dose received by 90% of the HRCTV was 80.8Gy EQD2 in CT based intracavitary brachytherapy and 89.48Gy EQD2 in MR based hybrid brachytherapy. The mean bladder, rectum, sigmoid and small bowel D2cc doses were 63.87Gy, 62.18Gy, 61.2Gy and 55.1Gy EQD2 respectively.</p><p><strong>Conclusion: </strong>This report demonstrates successful implementation and change of carcinoma cervix treatment practice pattern through workshop and mentoring across a network of radiotherapy centers in India.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901216","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":"Impact of robust optimization on patient specific error thresholds for high dose rate prostate brachytherapy source tracking.","authors":"Dylan Koprivec, Cedric Belanger, Luc Beaulieu, Philippe Y Chatigny, Anatoly Rosenfeld, Dean Cutajar, Marco Petasecca, Andrew Howie, Joseph Bucci, Joel Poder","doi":"10.1016/j.brachy.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.brachy.2024.11.012","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to compare the effect of catheter shift errors and determine patient specific error thresholds (PSETs) for different high dose rate prostate brachytherapy (HDRPBT) plans generated by different forms of inverse optimization.</p><p><strong>Methods: </strong>Three plans were generated for 50 HDRPBT patients and PSETs were determined for each of the 3 plans. Plan 1 was the original Oncentra Prostate (v4.2.2.4, Elekta Brachytherapy, Veenendaal, The Netherlands) plan, the second plan used the graphical processor unit multi-criteria optimization (gMCO) algorithm, and plan 3 used gMCO but had a robustness parameter as an additional optimization criterion (gMCOr). gMCO and gMCOr plans were selected from a pool of 2000 pareto optimal plans. gMCO plan selection involved increasing prostate V100% and reducing rectum Dmax/urethra D01.cc progressively until only 1 plan remained. The gMCOr plan was the most robust plan (using robustness parameter) that met the clinical DVH criteria (V100% ≥ 95%, rectum Dmax ≤ 80%, urethra D0.1cc ≤ 118%). PSETs were determined using catheter shift software.</p><p><strong>Results: </strong>The initial dose volume histogram (DVH) characteristics showed all 50 patient plans met a prostate V100% > 95% and resulted in significant reduction in rectum Dmax and urethra D0.1cc for gMCO and gMCOr plans. No single plan showed benefits in PSETs for all shift directions compared to the other plans, however gMCO and gMCOr plans exhibit the best initial DVH characteristics assuming no errors occur. The robustness parameter showed no significant impact when considered in plan optimization.</p><p><strong>Conclusions: </strong>PSETs were found to be equivalent regardless of optimization method. Indicating, no single optimization method can significantly increase the patient specific thresholds.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848628","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}