Interactive-plan technique conquers the disadvantages of volume-reducing hormone therapy in 125I permanent implantation for localized prostate cancer
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Hiromichi Ishiyama1, Takefumi Satoh, Masashi Kitano
1Department of Radiology, Kitasato University School of Medicine, Sagamihara, Japan. hishiyam@kitasato-u.ac.jp
Background:
The purpose of this study was to assess the impact of hormone therapy on post-implant dosimetry in patients in whom pre-plan and interactive-plan techniques were used for transperineal brachytherapy against prostatic cancer.
Methods:
The subjects comprised 244 patients treated using (125)I seed implantation as monotherapy. The prescribed dose to the periphery of the prostate was 145 Gy. The pre-plan technique was used for 116 patients, and the interactive-plan technique for 128 patients. Hormone therapy was used in 71 patients (29.1%). The D90 (dose to 90% of prostate volume) of post-implant computed tomography (CT) analysis was assessed in both groups. In addition, the ratio of post-implant CT volume to preoperative ultrasonography (US) volume was assessed.
Results:
In the pre-plan group, D90 was significantly lower for patients who received hormone therapy than for those who did not (P = 0.035). However, in the interactive-plan group, D90 did not differ between patients with and without hormone therapy (P = 0.467). The CT-to-US prostate volume ratio was 1.022 for patients who received hormone therapy and 0.960 for patients who did not (P = 0.021).
Conclusion:
Post-traumatic swelling following implantation is increased by cessation of hormone therapy and may reduce D90. However, the present results suggest that the interactive-plan technique overcomes this disadvantage of hormone therapy.
