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Related Experiment Videos

High dose-rate afterloading 192Iridium prostate brachytherapy: feasibility report

T P Mate1, J E Gottesman, J Hatton

  • 1Seattle Prostate Institute, Swedish Hospital Medical Center, WA 98104, USA.

International Journal of Radiation Oncology, Biology, Physics
|July 4, 1998
PubMed
Summary

High dose rate 192Iridium brachytherapy (HDR-Ir192) combined with external beam radiation is a feasible and well-tolerated treatment for prostate cancer. This approach offers precise dosimetry and effective tumor control, with acceptable side effects.

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Localized prostate cancer treatment using seed implants shows encouraging results.
  • Current seed implantation techniques can lead to inadequate dosimetry.
  • Remote afterloading high dose rate 192Iridium brachytherapy (HDR-Ir192) offers improved dosimetry control by performing it after needle placement.

Purpose of the Study:

  • To determine the feasibility of using multifractionated HDR-Ir192 in prostate cancer brachytherapy.
  • To evaluate the efficacy and safety of this combined treatment approach.

Main Methods:

  • 104 patients with prostate carcinoma received a combination of multifractionated HDR-Ir192 and external beam radiation.
  • Ultrasound-guided perineal needle placement followed by CT-based dosimetry.

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  • Four HDR-Ir192 fractions were delivered, followed by 50.40 Gy external beam radiation over 28 fractions.

    • Main Results:

    • The technique was applicable to various prostate volumes and well-tolerated.
    • 6.7% of patients developed manageable urethral strictures; technique changes reduced incidence.
    • Approximately 84% of patients with initial PSA < 20 ng/ml were free of progression at 5 years.

    Conclusions:

    • Transperineal ultrasonography, CT-based dosimetry, and remote afterloading HDR-Ir192 provide excellent control for prostate brachytherapy.
    • This method is advantageous for base-located carcinomas, extensive intraprostatic tumors, and large glands.
    • Early data suggest HDR-Ir192 is an effective definitive treatment with acceptable late effects, though longer follow-up is necessary.