Brachytherapy最新文献

{"title":"Improved outcomes in primary hepatocellular carcinoma adjacent to large vessels: A combined approach of MRI-guided radiofrequency ablation and 125I implantation","authors":"Xianhua Miao ,&nbsp;Rui Guo ,&nbsp;Qingfeng Lin ,&nbsp;Zhengyu Lin","doi":"10.1016/j.brachy.2025.12.005","DOIUrl":"10.1016/j.brachy.2025.12.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To assess the clinical efficacy and feasibility of combining MRI-guided radiofrequency ablation (RFA) with ¹²⁵I seed brachytherapy for hepatocellular carcinoma (HCC) adjoining large vessels (≥3 mm diameter).</div></div><div><h3>MATERIALS AND METHODS</h3><div>This single-center, retrospective cohort study analyzed prospectively collected data from March 2010 to March 2017. Approved by the institutional ethics review board, this retrospective analysis evaluated 84 patients with HCC situated near major vasculature, treated from March 2010 to March 2017. A total of 97 tumors underwent MRI-guided RFA combined with ¹²⁵I seed implantation. Outcome measures included technical success, overall survival (OS), recurrence-free survival, local tumor progression, and comparative analyses between treatment-naive and previously treated subgroups.</div></div><div><h3>RESULTS</h3><div>All interventions were completed without complications, achieving a primary technical efficacy rate of 98.81% (83/84). Postimplantation dosimetry confirmed adequate coverage in all cases (median D90 118 Gy, V100 94%). No seed migration or radiation-related toxicity (including radiation-induced liver disease) was recorded. The mean OS was 30.96 ± 18.98 months, with 1-, 3-, 5-, and 7-year OS rates of 100%, 98.20%, 87.10%, and 72.80%, respectively. Disease recurrence developed in 38.10% (32/84) of patients at a mean of 16.84 ± 13.61 months. Local tumor progression occurred in 7.1% (6/84). Significant intergroup differences emerged in portal hypertension (<em>p</em> = 0.009) and baseline AFP levels (<em>p</em> = 0.0015), with the treatment-naïve group demonstrating superior survival outcomes (<em>p</em> = 0.012).</div></div><div><h3>CONCLUSIONS</h3><div>The combined approach of MRI-guided RFA and ¹²⁵I brachytherapy represents a safe and effective strategy for managing HCC near major vasculature, providing high technical success rates and durable survival outcomes. Early intervention in treatment-naïve patients may be critical for outcome optimization. Prospective multicenter trials with extended follow-up are warranted to confirm these observations.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 333-341"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rectal spacers in high-dose-rate-brachytherapy: Optimizing peripheral zone radiation delivery","authors":"Christopher A. Cronkite ,&nbsp;David Lakomy ,&nbsp;Arjit Baghwala ,&nbsp;Ramiro Pino ,&nbsp;Andrew M. Farach","doi":"10.1016/j.brachy.2025.10.014","DOIUrl":"10.1016/j.brachy.2025.10.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The utilization of rectal spacers (RS) in prostate cancer treated with definitive radiotherapy has been shown to provide rectal dose sparing, decreased rectal toxicity, and improved gastrointestinal quality-of-life metrics. This dose-sparing effect presents an opportunity for dose escalation to the prostate, potentially enhancing clinical and biochemical outcomes while minimizing adverse effects. Although the influence of RS on overall prostate dosimetry has yielded mixed findings, the specific impact on radiation delivery to the predominantly tumorigenic peripheral zone (PZ) remains largely unexamined. This study aims to evaluate the effects of RS on PZ dosimetry in prostate brachytherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A single-institution, retrospective analysis was conducted on patients who received two-fraction high-dose-rate brachytherapy (HDR-BT) for localized prostate cancer. Dosimetric parameters and biochemical outcomes were compared between consecutive patients who received intraoperative RS (RS+) and those who did not (RS−). Additional subset analysis was performed stratifying by prostate size. Comparisons were performed using the Mann–Whitney &lt;em&gt;U&lt;/em&gt; test. Dosimetric parameters were assessed for the prostate, planning target volume, PZ, and organs at risk (OAR).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Between January 2020 and July 2024, a total of 92 patients who underwent HDR-BT were identified, of whom 46 (50%) were RS+. The contoured volumes of the prostate and PZ were comparable between the RS− and RS+ cohorts, with a median of 38.5 vs. 34.96 cm&lt;sup&gt;3&lt;/sup&gt; (&lt;em&gt;p&lt;/em&gt; = 0.4475) and 11.25 vs. 10.25 (&lt;em&gt;p&lt;/em&gt; = 0.1964), respectively, for the prostate and PZ. However, median PZ &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;90&lt;/sub&gt; was significantly higher in RS+ patients compared to RS− (RZ+ 115.65% vs. 110.25%, &lt;em&gt;p&lt;/em&gt; &lt; 0.0001). The increase in PZ &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;90&lt;/sub&gt; in the RS+ group was more pronounced in patients with smaller prostates (&lt;40 cm&lt;sup&gt;3&lt;/sup&gt;: RS+ 115.97% vs. 108.87%, &lt;em&gt;p&lt;/em&gt; &lt; 0.0001). Regarding organs at risk, the RS+ group exhibited a reduction in rectal &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;max&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; &lt; 0.0001), &lt;em&gt;V&lt;/em&gt;&lt;sub&gt;20&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; = 0.0002), &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;80&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; &lt; 0.0001), and &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;2cc&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; &lt; 0.0001); a decrease in urethral &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;max&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; = 0.0017) and &lt;em&gt;V&lt;/em&gt;&lt;sub&gt;110&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; = 0.0002); and an increase in bladder &lt;em&gt;V&lt;/em&gt;&lt;sub&gt;75&lt;/sub&gt; and &lt;em&gt;D&lt;/em&gt;&lt;sub&gt;80&lt;/sub&gt; (&lt;em&gt;p&lt;/em&gt; &lt; 0.0001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;As expected, RS HDR-BT successfully reduced rectal radiation exposure in this cohort. RS use is associated with increased radiation delivery to the PZ, potentially augmenting ablative dosing to the primary site of disease and the most likely zone for potential microscopic intraprostatic spread, as well as decreased urethral doses. This enhanced dose distribution within the P","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 396-401"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes with triple tandem brachytherapy for medically inoperable endometrial cancer in a high-risk patient population","authors":"Michael Jason Gutman ,&nbsp;Tianming Wu ,&nbsp;Aranee Sivananthan ,&nbsp;Hania Al-Hallaq ,&nbsp;Christina Son ,&nbsp;Yasmin Hasan","doi":"10.1016/j.brachy.2025.10.010","DOIUrl":"10.1016/j.brachy.2025.10.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The purpose of this study is to evaluate clinical outcomes for medically inoperable endometrial cancer (MIEC) patients treated with triple tandem brachytherapy (TTB) ± external beam radiation therapy (EBRT).</div></div><div><h3>METHODS</h3><div>This single institution retrospective review analyses MIEC patients treated definitively with TTB ± EBRT from 2014 to 2021. FIGO stage I–II with Grade 1–2 histology were considered low-risk endometrial cancer (LREC) and FIGO stage III–IVB and/or any Grade 3 endometrioid carcinoma, clear cell, or serous carcinoma were considered high-risk endometrial cancer (HREC). Planning parameters for target volume(s) and OARs (organs at risk) were per ABS guidelines. Overall survival (OS) and local failure-free survival (LFFS) were estimated by Kaplan-Meier analysis. Local control (LC), acute and late toxicities were evaluated clinically.</div></div><div><h3>RESULTS</h3><div>Of 26 patients, 92.3% (<em>n</em> = 24) received TTB + EBRT. The median age at diagnosis was 66.5 years (40.5–88.7 years). Median follow up was 41.1 months (1.7–109.9 months). Median prescribed doses to the uterus were 45 Gy (0–50.4 Gy) for EBRT and 22.25 Gy (18–49.1 Gy) for TTB. 53.8% (<em>n</em> = 14) had LREC and 46.2% (<em>n</em> = 12) had HREC. 88.5% had endometrioid histology. The median OS for the entire cohort was 43.5 months with no difference for the LREC and HREC (<em>p</em> = 0.563). LC was superior (<em>p</em> = 0.032) in LREC patients (100% 4-year LFFS) with all recurrences occurring in the HREC cohort (1-/4-year LFFS 90.9%/62.3%). Late toxicities &gt; Grade 2 were: Grade 2 GU (<em>n</em> = 2) and Grade 2 GI (<em>n</em> = 1).</div></div><div><h3>CONCLUSIONS</h3><div>Definitive TTB ± EBRT for MIEC patients was associated with excellent LFFS and acceptable toxicity rates.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 283-290"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A first-in-human randomized clinical trial of graphics processing units based multi-criteria optimization (gMCO) versus IPSA in high-dose-rate prostate brachytherapy","authors":"F. Lacroix ,&nbsp;E. Poulin ,&nbsp;C. Bélanger ,&nbsp;S. Aubin ,&nbsp;D. Carignan ,&nbsp;E. Vigneault ,&nbsp;A.-G. Martin ,&nbsp;F. Bachand ,&nbsp;L. Beaulieu ,&nbsp;W. Foster","doi":"10.1016/j.brachy.2025.11.009","DOIUrl":"10.1016/j.brachy.2025.11.009","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The purpose of this work, a first-in-human randomized clinical trial, was to compare gMCO, a GPU-based multi criteria optimization (MCO) algorithm, to reference plans in terms of planning time and plan quality for prostate HDR brachytherapy.</div></div><div><h3>METHODS AND MATERIALS</h3><div>The brachytherapy procedure was as follows: (<em>1</em>) Patient installation, (<em>2</em>) Catheter implantation under transrectal ultrasound (US) guidance, (<em>3</em>) 3D US scan, (<em>4</em>) Contouring/catheter reconstruction on Oncentra Prostate (Elekta, Veenendaal, Netherlands), (<em>5</em>) Planning, (<em>6</em>) Treatment. Planning (step 5) was performed, after randomization, using either IPSA (Oncentra Prostate, Veenendaal, Netherlands) or gMCO. The planning times on IPSA or gMCO were recorded. Patients previously had a planning MR in order to identify whether a gross tumor volume (GTV, PIRADS 3 and above) was visible and, if present, the GTV was boosted to a minimum of 19 Gy of the prescription dose. Fifty-five patients were accrued and distributed randomly between both treatment arms. Dosimetric indices (Prostate V100, V150, V200, GTV D90, Urethra D10, Rectum and Bladder V75 and D1cc) of gMCO and Inverse-Planning Simulated Annealing algorithm (IPSA) plans were compared to determine if plan quality and planning times were statistically different.</div></div><div><h3>RESULTS</h3><div>Results show that the optimization time is reduced by half when using gMCO as compared to IPSA, going from 10–5.2 minutes. Although no statistically significant difference is present between gMCO and IPSA plans when comparing pairs of individual dosimetric indices, gMCO plans exhibit a higher pass rate (higher by a factor ranging from 1.3 to 1.6), as compared to IPSA, when considering a basket of dosimetric indices simultaneously.</div></div><div><h3>CONCLUSION</h3><div>The use of gMCO halves the planning time for prostate HDR brachytherapy as compared to IPSA, without decreasing plan quality. The overall gain in efficiency related to the planning process has led to the use of gMCO for all of our HDR prostate cases.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 354-360"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicator reconstruction in cervical cancer brachytherapy: A systematic review of current methods, challenges, and AI-driven future directions","authors":"Vida Sargazi ,&nbsp;Shahrokh Naseri ,&nbsp;Hamid Gholamhosseinian ,&nbsp;Mehdi Momennezhad","doi":"10.1016/j.brachy.2025.10.004","DOIUrl":"10.1016/j.brachy.2025.10.004","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Accurate applicator reconstruction is a critical step in 3D image-guided brachytherapy (3D-IGBT) for cervical cancer, directly influencing tumor control and organ-at-risk sparing. This systematic review evaluates the accuracy, efficiency, and clinical impact of applicator reconstruction methods, focusing on AI’s potential to overcome existing limitations.</div></div><div><h3>METHODS AND MATERIALS</h3><div>Following PRISMA guidelines, 23 studies from MEDLINE, PubMed, Scopus, Embase, Lilacs and Web of Science (up to May 2025) were analyzed. Evaluation metrics included geometric accuracy (tip error, Hausdorff distance), reconstruction time, and dosimetric parameters (D90 HR-CTV, D2cc OARs). Methods assessed spanned manual (e.g., MPR, scout-based), semi-automatic (library method, clustering algorithms), and AI-driven approaches (e.g., U-Net, Dilated-Supervised Deep U-Net, Attention-Gated networks). Special focus was placed on deep learning (DL) architectures and their ability to overcome metallic artifacts, partial-volume effects, and inter-operator variability.</div></div><div><h3>RESULTS</h3><div>Manual methods exhibited significant limitations, with tip errors reaching 4.1 mm. Semi-automated approaches reduced variability (library-based methods: &lt;0.5 mm mean deviation) but remained constrained by predefined applicator models. AI-driven workflows demonstrated superior precision, achieving submillimeter accuracy (median tip error: 0.64 mm; Dice Similarity Coefficient (DSC) &gt; 0.89) and dosimetric consistency (D2cc deviations &lt;3%). Notably, DL models like DSD-UNet and Attention-Gated U-Net reduced reconstruction time to &lt;30 s per case while maintaining robustness against CT artifacts. However, challenges persist, including limited clinical validation (60% of studies used phantoms), data heterogeneity (slice thickness: 0.6–5 mm), and generalizability to novel applicator designs.</div></div><div><h3>CONCLUSION</h3><div>AI-driven reconstruction reduces human-dependent errors and enhances efficiency, but clinical validation remains a priority. Reducing CT slice thickness (≤1.5 mm) and combining scout images to mitigate metal artifacts are recommended. Future research should focus on generalizable AI models for nonlibrary applicators and large-scale clinical validation.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 262-274"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between rectal spacer use and bowel, urinary, and sexual dysfunction following prostate cancer brachytherapy: U.S. claims data analysis","authors":"Michael R. Folkert ,&nbsp;Emily S. Weg ,&nbsp;Ryoko Sato ,&nbsp;James B. Yu ,&nbsp;Samir Bhattacharyya ,&nbsp;Emmanuel Ezekekwu ,&nbsp;Daniel A. Hamstra","doi":"10.1016/j.brachy.2025.10.015","DOIUrl":"10.1016/j.brachy.2025.10.015","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Rectal spacing has been shown to reduce toxicity following external beam radiation therapy for prostate cancer. However, real-world evidence of effectiveness for rectal spacers with brachytherapy (BT) monotherapy remains limited. This study used U.S. claims datasets to assess the association between rectal spacer use and bowel, urinary, and sexual function following BT.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A retrospective study was conducted among patients treated with BT monotherapy for prostate cancer between 2015 and 2021, using Medicare 5% and 100% Files, MarketScan, and Premier Databases. Polyethylene glycol rectal spacer use was identified. Post-BT treatment diagnoses of bowel, urinary, and sexual dysfunction were evaluated using Cox proportional hazards models, adjusting for age, comorbidity, region, baseline dysfunction, secondary cancers, and BT modality (low-dose rate [LDR] or high-dose rate).</div></div><div><h3>RESULTS</h3><div>Among 13,858 BT monotherapy patients, 1198 (8.6%) received a spacer. Patients with spacer were younger and had fewer baseline dysfunctions. At 5-year median follow-up, spacer use was associated with significantly lower incidence of bowel (adjusted hazard ratio, aHR: 0.76, <em>p</em> = 0.027) and urinary (aHR: 0.84, <em>p</em> = 0.008) dysfunction. Sexual dysfunction trended lower (aHR: 0.79, <em>p</em> = 0.120), although not significant. In LDR patients, spacer use remained significantly associated with reduced bowel (aHR: 0.74, <em>p</em> = 0.021) and urinary (aHR: 0.83, <em>p</em> = 0.005) dysfunction. Significant associations were not found in high-dose rate patients.</div></div><div><h3>CONCLUSIONS</h3><div>In this large real-world study, rectal spacing as a standard-of-care intervention showed sustained significant benefit in reducing bowel and urinary dysfunction, which appeared to be greatest in those treated with LDR BT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 402-409"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National patterns of brachytherapy boost use for intermediate- and high-risk prostate cancer: Bridging the gap between evidence and practice","authors":"Alicia C. Smart ,&nbsp;Yetkin Tuac ,&nbsp;Zhiyu Qian ,&nbsp;Grgur Mirić ,&nbsp;Peter F. Orio ,&nbsp;Martin T. King ,&nbsp;Mutlay Sayan","doi":"10.1016/j.brachy.2025.10.008","DOIUrl":"10.1016/j.brachy.2025.10.008","url":null,"abstract":"<div><h3>Background</h3><div>Brachytherapy boost in combination with external beam radiation therapy (EBRT-BT) improves biochemical progression-free survival in patients with intermediate- and high-risk prostate cancer. However, its adoption in routine clinical practice remains uncertain. We aimed to evaluate national trends and factors associated with the use of EBRT-BT following the publication of the ASCENDE-RT trial.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used data from the Surveillance, Epidemiology, and End Results (SEER) database from 2015 to 2020. We included men with intermediate- or high-risk localized prostate cancer who received EBRT with or without brachytherapy boost as their sole initial treatment. The primary outcome was receipt of brachytherapy boost. Trends in use were assessed by year of diagnosis, and multivariable logistic regression was used to identify clinical and demographic factors associated with EBRT-BT.</div></div><div><h3>Results</h3><div>Among 507,327 men with prostate cancer, 48,777 (9.6%) met inclusion criteria. Of these, 6775 (13.9%) received EBRT-BT. Use increased modestly from 12.4% in 2015 to 14.6% in 2020 among patients with unfavorable intermediate-risk disease, and from 12.5% to 15.2% in those with high-risk disease. In multivariable analysis, use of EBRT-BT was significantly associated with younger age, higher Gleason grade group, and advanced T stage (all <em>p</em> &lt; 0.001). Compared with 2015, EBRT-BT use was more likely in 2018–2020 (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Despite level 1 evidence and guideline support, brachytherapy boost remains underutilized. These findings highlight a persistent gap between evidence and practice and underscore the need for strategies to expand access to EBRT-BT and promote its use where clinically appropriate.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 300-305"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric impact of androgen deprivation therapy (ADT)-induced prostate deformation in low-dose-rate prostate brachytherapy","authors":"Younghun Yoon ,&nbsp;Wooshik Kim ,&nbsp;Han-Back Shin ,&nbsp;Jihun Kim ,&nbsp;Jaeho Cho","doi":"10.1016/j.brachy.2025.11.006","DOIUrl":"10.1016/j.brachy.2025.11.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Androgen deprivation therapy (ADT) for prostate cancer typically reduces prostate volume. This study investigated how the timing of ADT relative to low-dose-rate (LDR) brachytherapy influences the resulting dosimetric outcomes.</div></div><div><h3>METHODS</h3><div>Using deformable image registration and principal component analysis on pre- and post-ADT magnetic resonance images of 34 patients, we developed a statistical model of ADT-induced prostate deformation. We applied this model to 30 low-dose-rate (LDR) brachytherapy plans (prescription dose: 145 Gy) to simulate seed displacement and dose distribution changes from prostate shrinkage. Prostate deformation over time post-ADT was categorized into early, linear, and late response phases. Dosimetric outcomes were analyzed across scenarios with varying prostate volume reduction magnitudes and different intervals between ADT initiation and brachytherapy.</div></div><div><h3>RESULTS</h3><div>When ADT was initiated concurrently with brachytherapy, the model predicted substantial dose escalation if prostate shrinkage occurred early (prostate D90 ∼206 Gy; urethral V200 ∼47.7%) compared to late shrinkage response (D90 ∼183 Gy; V200 ∼7.1%). In contrast, separating the treatments in time greatly mitigated this effect. For example, assuming early response, performing brachytherapy 3 months before ADT yielded a prostate D90 of ∼183.0 Gy (urethral V200 ∼7.7%), while delaying brachytherapy to 3 months after ADT yielded a D90 of ∼177.8 Gy (V200 ∼1.2%).</div></div><div><h3>CONCLUSIONS</h3><div>Dosimetric analysis showed that greater prostate volume reduction, early ADT response, and concurrent ADT all corresponded to substantially increased doses to the prostate and urethra. Clinically, these findings underscore the importance of carefully planning the timing of ADT relative to brachytherapy to optimize target coverage and minimize unintended dose escalation to normal tissues.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 342-353"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on “high-dose-rate (HDR) brachytherapy boost in combination with external beam radiotherapy for localized prostate cancer: An evidence-based consensus statement”","authors":"S. Dhanya Dedeepya ,&nbsp;Vaishali Goel ,&nbsp;Nivedita Nikhil Desai","doi":"10.1016/j.brachy.2025.10.001","DOIUrl":"10.1016/j.brachy.2025.10.001","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 251-252"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Good safety of oblique needle insertion using the Venezia applicator for cervical cancer: A single-center cohort study","authors":"Jean-François Py,&nbsp;Sophie Renard,&nbsp;William Gehin,&nbsp;Nicolas Martz,&nbsp;Claire Charra-Brunaud,&nbsp;Marie Bruand","doi":"10.1016/j.brachy.2025.09.002","DOIUrl":"10.1016/j.brachy.2025.09.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate procedural complications associated with the use of the Venezia applicator with oblique needles for treating locally advanced cervical cancer (LACC).</div></div><div><h3>METHODS</h3><div>We conducted a retrospective analysis of 30 patients treated at our center between November 2019 and August 2024 using the Venezia applicator. All patients underwent combined intracavitary and interstitial brachytherapy with oblique needle implantation. Procedural complications were classified using the Clavien-Dindo classification, focusing on organ perforations and bleeding events.</div></div><div><h3>RESULTS</h3><div>The median age was 54.5 years. Most patients (90%) had squamous cell carcinoma, and the predominant stage FIGO was T3b (46.7%). The median HR-CTV volume was 32.8cc [24.5–39.3] and the median HR-CTV D90 was 86.0 Gy [82.7–90.5]. All organ at risk dose constraints were respected. Oblique needle perforation occurred in 7/30 patients (23.3%) and in 16/130 needles (12.3%), most often in the bladder. The majority (96.7%) experienced no or mild complications (grade 0–1). The most common complication was minor bleeding during applicator removal, controlled with manual compression. One patient experienced grade 2 bleeding requiring transfusion. No grade 3–5 complications were observed.</div></div><div><h3>CONCLUSION</h3><div>The use of the Venezia applicator with oblique needles for locally advanced cervical cancer (LACC) appears safe and feasible, with a low rate of significant complications. Oblique needle insertion facilitates distal parametrial coverage, making it a valuable tool for challenging tumor extensions.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 1","pages":"Pages 50-55"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}