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Use of Gold Markers for Setup in Image-Guided Fractionated High-Dose-Rate Brachytherapy as a Monotherapy for Prostate Cancer = Nutzen von Goldmarkern zur Konfiguration bei der bildgestützten, fraktionierten High-Dose-Rate-Brachytherapie als Monotherapie des Prostatakarzinoms

Ghadjar, Pirus ; Gwerder, Nicole ; Madlung, Axel ; Behrensmeier, Frank ; Thalmann, George ; Mini, Roberto ; Aebersold, Daniel

In: Strahlentherapie und Onkologie, 2009, vol. 185, no. 11, p. 731-735

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    Titre
    • Use of Gold Markers for Setup in Image-Guided Fractionated High-Dose-Rate Brachytherapy as a Monotherapy for Prostate Cancer
    Titre traduit ()
    • Nutzen von Goldmarkern zur Konfiguration bei der bildgestützten, fraktionierten High-Dose-Rate-Brachytherapie als Monotherapie des Prostatakarzinoms
    Auteur
    • Ghadjar, Pirus. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Gwerder, Nicole. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Madlung, Axel. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Behrensmeier, Frank. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Thalmann, George. Department of Urology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Mini, Roberto. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    • Aebersold, Daniel. Department of Radiation Oncology with Division of Medical Radiation Physics, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Strahlentherapie und Onkologie, 2009, vol. 185, no. 11, p. 731-735. Urban and Vogel
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:321768
    Summary
    Background and Purpose: : In order to use a single implant with one treatment plan in fractionated high-dose-rate brachytherapy (HDR-B), applicator position shifts must be corrected prior to each fraction. The authors investigated the use of gold markers for X-ray-based setup and position control between the single fractions. Patients and Methods: : Caudad-cephalad movement of the applicators prior to each HDR-B fraction was determined on radiographs using two to three gold markers, which had been inserted into the prostate as intraprostatic reference, and one to two radiopaque-labeled reference applicators. 35 prostate cancer patients, treated by HDR-B as a monotherapy between 10/2003 and 06/2006 with four fractions of 9.5 Gy each, were analyzed. Toxicity was scored according to the CTCAE Score, version 3.0. Median follow-up was 3 years. Results: : The mean change of applicators positions compared to baseline varied substantially between HDR-B fractions, being 1.4 mm before fraction 1 (range, -4 to 2 mm), -13.1 mm before fraction 2 (range, -36 to 0 mm), -4.1 mm before fraction 3 (range, -21 to 9 mm), and -2.6 mm at fraction 4 (range, -16 to 9 mm). The original position of the applicators could be readjusted easily prior to each fraction in every patient. In 18 patients (51%), the applicators were at least once readjusted > 10 mm, however, acute or late grade ≥ 2 genitourinary toxicity was not increased (p = 1.0) in these patients. Conclusion: : Caudad position shifts up to 36 mm were observed. Gold markers represent a valuable tool to ensure setup accuracy and precise dose delivery in fractionated HDR-B monotherapy of prostate cancer