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Dosimetric comparison of pre-planned and or-planned prostate seed brachytherapy
D A Wilkinson1, E J Lee, J P Ciezki
1Department of Radiation Oncology, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. wilkinson@radonc.ccf.org
Purpose:
To compare the dosimetry of the traditional two step procedure (volume study + treatment planning several weeks later) with that of an OR-based single procedure in which these two steps follow one another immediately. Computer generated treatment plans were used in both procedures.
Methods And Materials:
Several dosimetric parameters relating to target coverage were obtained from dose volume histograms of CT-based evaluation plans developed either 1 or 3 days following seed implantation. A total of 113 patients with early stage (T1C, T2A) prostate cancer were used for this retrospective study.
Results:
The fraction of target (prostate) covered by the prescription dose (144 Gy), 90% of the prescription dose (115 Gy), and the dose encompassing 90% of the target in the evaluation plan were all statistically significantly improved for OR-based plans compared to pre-planned cases.
Conclusion:
In our hands, there is a small but significant improvement in dose coverage of the prostate when the ultrasound volume study and treatment planning are combined into a single procedure.