Prostate cancer boost using high-dose-rate brachytherapy: Impact of the learning curve on the dosimetry - Abstract

PURPOSE: To analyse the influence of the learning curve on dosimetric data for high-dose-rate brachytherapy prostate cancer boost.

PATIENTS AND METHODS: From February 2009 to May 2012, after a first course of external beam radiation therapy (46Gy/23 fractions), 124 patients underwent high-dose-rate brachytherapy boost using Plato™ (Nucletron, an Elekta company, Elekta AB, Stockholm, Sweden). The impact of the learning curve on the dosimetric quality of the prostate implant was assessed. The dosimetric data have been analysed: clinical target volume (CTV), D90 (dose to 90 % of CTV), D100, V100 (part on the CTV receiving 100 % of the dose), V150, V200 and DHI (dose non-homogeneity index). The doses delivered to 0.1, 1 and 2 cm3 of the rectum and urethra were calculated.

RESULTS: During the study period (39 months), a significant reduction of V150 (P< 0.001), V200 (P< 0.001), D0.1rectum (P<0.001), D1rectum (P< 0.001), D2rectum (P< 0.001), D0.1urethra (P< 0.001), and D1urethra (P< 0.002) was observed associated with a significant degradation of the D90 (P< 0.001) but not significant for the V100 (P=0.29) and the D100 (P=0.3).

CONCLUSION: This study confirms that the dosimetric quality of high-dose-rate brachytherapy prostate implant is significantly improved during the learning curve period.

Written by:
Benhaïm C, Chand ME, Gal J, Hijazi H, Gautier M, Hannoun-Lévi JM.   Are you the author?
Département de radiothérapie, centre Antoine-Lacassagne, université Nice-Sophia, 33, avenue de Valombrose, 06000 Nice, France; Département de radiothérapie, centre Jean-Perrin, université d'Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France; Unité de biostatistique, centre Antoine-Lacassagne, université Nice-Sophia, 33, avenue de Valombrose, 06000 Nice, France.  

Reference: Cancer Radiother. 2014 Aug 27. pii: S1278-3218(14)00103-6.
doi: 10.1016/j.canrad.2014.04.008

PubMed Abstract
PMID: 25176296

Article in French. Prostate Cancer Section