Feasibility of balloon rectal spacer implantation in HDR and LDR brachytherapy for prostate cancer treatment

IF 1.7 4区医学 Q4 ONCOLOGY Brachytherapy Pub Date : 2025-01-01 DOI:10.1016/j.brachy.2024.10.003

Tomer Charas, Salem Billan

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Abstract

PURPOSE

This study evaluates the use of a biodegradable balloon rectal spacer in two prostate cancer patients undergoing low dose radiation (LDR) and salvage high dose radiation (HDR) brachytherapy. The spacer aims to reduce radiation dose to adjacent organs, particularly the rectum, in patients previously treated with radiation.

METHODS

The balloon spacer was implanted transperineally under transrectal ultrasonography (TRUS) guidance in two patients. For the LDR case (73-year-old, intermediate-risk), the balloon was placed postimplant with 55 iodine-125 seeds delivering 145 Gy. For the HDR case (66-year-old, high-risk), the balloon was placed one week before treatment, which delivered 23 Gy in two weekly fractions using 16 channels.

RESULTS

The balloon provided a 14-15mm separation between rectum and prostate. In the LDR case, prostate D90 was 149.1Gy (102.83%), V100 was 91.95%, and rectum D30 was 23.93Gy (16.50%). For the HDR case, prostate D90 was 11.63Gy (105.79%), V100 was 93.63%, and rectum D0.5cc was 8.04Gy (73.15%). Both patients tolerated the treatment well, with no observed postoperative complications at 6-month follow-up.

CONCLUSIONS

The use of a rectal balloon spacer in both salvage HDR and LDR brachytherapy is feasible and safe, allowing for controlled placement and providing rectal protection from high radiation doses.

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在前列腺癌的 HDR 和 LDR 近距离放射治疗中植入球囊直肠垫片的可行性。

目的：本研究评估了生物可降解球囊直肠垫片在两名接受低剂量放射治疗（LDR）和挽救性高剂量放射治疗（HDR）近距离放射治疗的前列腺癌患者中的应用情况。该垫片旨在减少曾接受过放射治疗的患者邻近器官（尤其是直肠）的放射剂量：方法：在经直肠超声（TRUS）引导下，经会阴部为两名患者植入了球囊垫片。在 LDR 病例（73 岁，中危）中，球囊植入后放置了 55 颗碘-125 粒子，放射剂量为 145 Gy。对于 HDR 病例（66 岁，高风险），球囊在治疗前一周放置，使用 16 个通道，每周分两次释放 23 Gy：球囊在直肠和前列腺之间提供了 14-15 毫米的间隔。在 LDR 病例中，前列腺 D90 为 149.1Gy（102.83%），V100 为 91.95%，直肠 D30 为 23.93Gy（16.50%）。在 HDR 病例中，前列腺 D90 为 11.63Gy（105.79%），V100 为 93.63%，直肠 D0.5cc 为 8.04Gy（73.15%）。两名患者对治疗的耐受性良好，术后 6 个月随访时未观察到并发症：在抢救性 HDR 和 LDR 近距离放射治疗中使用直肠球囊垫片既可行又安全，既能控制放置位置，又能保护直肠免受高辐射剂量的伤害。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.

期刊最新文献

Masthead Table of Contents Editorial Board Towards U-Net-based intraoperative 2D dose prediction in high dose rate prostate brachytherapy High-dose-rate (2 fractions of 13.5 Gy) and low-dose-rate brachytherapy as monotherapy in prostate cancer. Long term outcomes and predictive value of nadir prostate-specific antigen