Prostate volume and implant configuration during 48 hours of temporary prostate brachytherapy: limited effect of oedema

Radiation Oncology

Arjan Bel¹  Rob van der Laarse¹  Niek van Wieringen¹  Kees Koedooder¹  Bradley R Pieters¹  Anna M Dinkla¹ 

[1] Department of Radiation Oncology, Academic Medical Center, Meibergdreef 9, Amsterdam, 1105, AZ, the Netherlands

关键词: Oedema;    Catheter displacement;    PDR;    HDR;    Brachytherapy;    Prostate cancer;   

Others  :  1150733
DOI  :  10.1186/s13014-014-0272-9

 received in 2014-03-07, accepted in 2014-11-22,  发布年份 2014

【 摘 要 】

Background

In pulsed-dose rate prostate brachytherapy the dose is delivered during 48 hours after implantation, making the treatment sensitive to oedematic effects possibly affecting dose delivery. The aim was to study changes in prostate volume during treatment by analysing catheter configurations on three subsequent scans.

Methods

Prostate expansion was determined for 19 patients from the change in spatial distribution of the implanted catheters, using three CT-scans: a planning CT (CT1) and two CTs after 24 and 48 hours (CT2, CT3). An additional 4 patients only received one repeat CT (after 24 hours). The mean radial distance (MRD) of all dwell positions to the geometric centre of all dwell positions used was calculated to evaluate volume changes. From three implanted markers changes in inter-marker distances were assessed. The relative shifts of all dwell positions were determined using catheter- and marker-based registrations. Wilcoxon signed-rank tests were performed to compare the results from the different time points.

Results

The MRDs measured on the two repeat CTs were significantly different from CT1. The mean prostate volume change derived from the difference in MRD was +4.3% (range −9.3% to +15.6%) for CT1-CT2 (p < .05) and +4.4% (range −7.5% to +16.3%) for CT1-CT3 (p < .05). These values represented a mean increase of 1.2 cm³ in the first 24 hours and 1.5 cm³ in the subsequent 24 hours. There was no clear sign of prostate expansion from the change in inter-marker distance (CT1-CT2: 0.2 ± 1.8 mm; CT1-CT3: 0.6 ± 2.2 mm). Catheter configuration remained stable; shifts in catheter positions were largest in the C-C direction: 0 ± 1.8 mm for CT1-CT2 and 0 ± 1.4 mm for CT2-CT3.

Conclusions

The volume changes derived from catheter displacements were small and therefore considered clinically insignificant. Implant configuration remains stable during 2 days of treatment, confirming the safety of this technique.

【 授权许可】

   
2014 Dinkla et al.; licensee BioMed Central Ltd.

【 图 表 】

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