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Can extraprostatic extension be treated by prostate brachytherapy? An analysis based on postimplant dosimetry
D Butzbach1, F M Waterman, A P Dicker
1Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
International Journal of Radiation Oncology, Biology, Physics
|December 1, 2001
Summary
Pd-103 prostate implants can treat extraprostatic extension (EPE) in favorable risk patients by delivering a 3-5 mm dose margin. However, achieving adequate dose coverage for EPE is operator-dependent, particularly at the prostate base.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Extraprostatic extension (EPE) is a prognostic factor in prostate cancer.
- Brachytherapy with Palladium-103 (Pd-103) seeds is a treatment option for prostate cancer.
Purpose of the Study:
- To evaluate the efficacy of Pd-103 prostate implants in treating EPE.
- To assess the dose margin delivered by Pd-103 implants at the prostate periphery.
Main Methods:
- Analysis of postimplant dosimetry from 22 Pd-103 prostate implants.
- Measurement of radial dose margins at various prostate locations using CT scans.
- Comparison of postimplant margins with preplan dose margins.
Main Results:
- Mean postimplant dose margins of >=4.5 mm were achieved at the midgland and apex.
- Mean dose margins at the prostate base were smaller than planned (2.5-3.5 mm) due to source placement errors.
- Source placement errors at the base are correctable and impact dose coverage.
Conclusions:
- Peripherally loaded Pd-103 implants can deliver a sufficient dose (3-5 mm) to treat EPE in favorable risk patients.
- Adequate dose coverage of EPE is dependent on the operator's technique and implant planning.
- Operator-dependent factors, particularly at the prostate base, require attention for optimal EPE treatment.
