Brachytherapy最新文献

{"title":"Ultrasound and CT-guided implantation of iodine-125 seeds combined with transarterial chemoembolization for recurrent hepatocellular carcinoma at complex sites after hepatectomy","authors":"Yeyan Wang ,&nbsp;Jie Feng","doi":"10.1016/j.brachy.2024.12.002","DOIUrl":"10.1016/j.brachy.2024.12.002","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>The objective of this study was to evaluate the efficacy and safety of TACE combined with 125I seeds (TACE-125I) in the treatment of recurrent HCC at complex sites after hepatectomy.</div></div><div><h3>METHODS</h3><div>This study retrospectively analyzed the clinical data of recurrent HCC patients located at complex sites (such as large blood vessels, diaphragm dome, etc.) after hepatectomy from January 2012 to December 2023, all of whom received TACE-125I or TACE therapy. Recur rence, overall survival (OS), progression-free survival (PFS) and complications were compared be tween the 2 groups.</div></div><div><h3>RESULTS</h3><div>A total of 152 patients with recurrent HCC were enrolled in this study, including 69 in the TACE-125I group and 83 in the TACE group. During follow-up, a total of 41 patients in the TACE-125I group experienced tumor recurrence, compared to 67 patients in the TACE group. The median OS in the TACE-125I group was 31 months, which was significantly higher than that in the TACE group (16 months, <em>p</em> &lt; 0.001). Similarly, the median PFS was significantly higher in the TACE-125I group than in the TACE group.</div></div><div><h3>CONCLUSIONS</h3><div>Compared with TACE treatment, TACE-125I may be a more effective method for the treatment of recurrent HCC located at complex sites.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 293-300"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043970","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":"Learning curve and proficiency assessment for gynecological brachytherapy amongst radiation oncology trainees in India: Results from a prospective study","authors":"Bharath Kumar ,&nbsp;Prachi Mittal ,&nbsp;Ankita Gupta ,&nbsp;Jaahid Mulani ,&nbsp;Rajesh Bhajbhuje ,&nbsp;Sadhana Kannan ,&nbsp;Jeevanshu Jain ,&nbsp;Supriya Chopra","doi":"10.1016/j.brachy.2024.11.013","DOIUrl":"10.1016/j.brachy.2024.11.013","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The quality of cervical cancer intracavitary brachytherapy (ICBT) depends on the training and experience of the radiation oncologist (RO). The present study was performed to establish primary learning curve for ICBT.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Forty-three skill parameters were identified for performing ICBT and were included for Brachytherapy Proficiency Assessment and Scoring System (Brachy-PASS) questionnaire. Brachy-PASS score was first compared with blinded objective scoring of implant quality for 10 trainees by two ROs. Twenty eight consecutive trainees were scored with Brachy-PASS by two RO's. The impact of number of procedures and training years was ascertained using Mann Whitney-U test. Minimum number of intracavitary procedures to attain proficiency (score<span><math><mo>≥</mo></math></span> 75%) were ascertained and learning curve plot of proficiency and procedures was generated.</div></div><div><h3>RESULTS</h3><div>Between January, 2022 to September, 2023 38 trainees were evaluated (20: post graduate year (PGY) 1-3, and 18: PGY 4-5) after due consent for skill evaluation. Good congruence was reported of objective scoring and Brachy-PASS (83.4% vs 88%). Ten trainees had performed &lt;15 ICBT, and 28 had performed ≥15 ICBT procedures. Overall 30/38 trainees (78.9%) achieved a Brachy-PASS score of ≥129 (75%). The average score for trainees with &lt;15 procedures was 126.6 (73.6%) vs 148.8 (86.5%) in trainees who performed ≥15 procedures. PGY 4-5 trainees had higher score (153.8 (89.4%) vs 134 (77.9%)). Learning curve threshold of 15 ICBT was identified to attain 75% score (129/172) with no plateauing of learning curve even with <span><math><mo>≥</mo></math></span>30 procedures.</div></div><div><h3>CONCLUSION</h3><div>Competency is established for independently performing intracavitary brachytherapy at 15 procedures and further increase in competency scores continues with increasing procedures.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 339-347"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017625","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":"Safety and early outcomes of proton therapy and low-dose rate brachytherapy boost for patients with prostate cancer","authors":"Osama Mohamad ,&nbsp;Zakaria El Kouzi ,&nbsp;Ramez Kouzy ,&nbsp;Seungtaek Choi ,&nbsp;Henry Mok ,&nbsp;Karen Hoffman ,&nbsp;Quynh-Nhu Nguyen ,&nbsp;Comron J Hassanzadeh ,&nbsp;Chad Tang ,&nbsp;Ryan J Park ,&nbsp;Shalin Jyotindra Shah ,&nbsp;Sean Eric McGuire ,&nbsp;Lauren Layer Mayo ,&nbsp;Yusung Kim ,&nbsp;Surendra Prajapati ,&nbsp;Sarath Vijayan ,&nbsp;Rajat J Kudchadker ,&nbsp;Teresa Lorraine Bruno ,&nbsp;Steven Jay Frank","doi":"10.1016/j.brachy.2024.12.003","DOIUrl":"10.1016/j.brachy.2024.12.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Brachytherapy boost improves biochemical control for patients with prostate cancer. Here, we report the safety and early efficacy of proton therapy (PT) with a low-dose-rate (LDR) brachytherapy boost.</div></div><div><h3>METHODS</h3><div>This retrospective study included patients with intermediate- or high-risk prostate cancer treated with PT followed by LDR boost, with or without androgen deprivation therapy (ADT), from 2010 through 2023. Patient, disease, and treatment characteristics, gastrointestinal (GI) and genitourinary (GU) toxicity, and efficacy outcomes are reported.</div></div><div><h3>RESULTS</h3><div>Ninety-nine patients received PT and LDR boost; median age at diagnosis was 68 years (interquartile range [IQR] 61–72). Most patients (<em>n</em> = 77) were White, 12 were African American, 5 Asian, and 3 Hispanic. Thirty-five patients had intermediate-risk (4 favorable and 31 unfavorable), 56 had high-risk, and 8 had very high-risk disease. Median PT dose was 44 Gy(RBE) (range 40–50.4) and median LDR dose was 90Gy (range 90–110). Pd-103 seed strands were used for 95 patients and I-125 for 4; 90 had MRI-assisted radiosurgery brachytherapy; 91 received ADT; and 21 had a rectal spacer. At a median follow-up time of 45 months, 5-year biochemical recurrence-free survival was 98%. There was no local recurrence, distant metastasis, or cancer death. Four patients had acute urinary retention after brachytherapy procedure. Eleven patients (11%) had late grade 2 GU toxicity, and 3 (3%) had late grade 2 GI toxicity. One patient had grade 3 urethral stricture requiring dilatation and transurethral resection.</div></div><div><h3>CONCLUSIONS</h3><div>At 45 months' follow-up time, treatment with PT and LDR boost led to high control rates and low toxicity for men with prostate cancer.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 301-309"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520850","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":"From patient to pioneer: The inspiring journey of Dr. Brian Moran","authors":"Manuj Agarwal ,&nbsp;Peter Orio","doi":"10.1016/j.brachy.2024.11.002","DOIUrl":"10.1016/j.brachy.2024.11.002","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 199-209"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025040","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":"HDR brachytherapy combined with external beam radiotherapy for unfavorable localized prostate cancer: A single center experience from inception to standard of care","authors":"Ka-Kit David Yeung ,&nbsp;Juanita Crook ,&nbsp;Gregory Arbour ,&nbsp;Cynthia Araujo ,&nbsp;Deidre Batchelar ,&nbsp;David Kim ,&nbsp;David Petrik ,&nbsp;Tracey Rose ,&nbsp;Francois Bachand","doi":"10.1016/j.brachy.2024.12.005","DOIUrl":"10.1016/j.brachy.2024.12.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>High dose rate (HDR) brachytherapy is increasingly adopted for dose escalation in prostate cancer treatment. We report the clinical efficacy and toxicity of HDR prostate brachytherapy combined with external beam radiotherapy (EBRT) and evaluate the predictability of the biochemical definition of cure of 4-year PSA ≤0.2 ng/mL for failure free survival (FFS).</div></div><div><h3>METHODS</h3><div>A single centre retrospective study was conducted, including all patients with high-tier intermediate risk and high-risk prostate cancer treated with HDR brachytherapy combined with EBRT from 2011 to 2019. Patient and prostate cancer characteristics, treatment, clinical endpoints, and follow up were collected.</div></div><div><h3>RESULTS</h3><div>Total 319 patients were analyzed. The median age was 68 with median follow up of 77.1 months. Total 142 had high-tier intermediate and 177 had high-risk disease. Brachytherapy doses were initially 20 Gy/2 fractions, and subsequently 15 Gy/1 fraction. All patients received 46 Gy/23 fractions of EBRT. Overall survival at 5 and 9 years was 92.2% and 77.0%, respectively. Failure-free survival (FFS) was 86.0% at 5 years and 76.1% at 9 years. PSA ≤ 0.2 ng/mL at 4 years was seen in 79.3% of patients and was associated with FFS of 94.1% at 9 years. Grade 3 urethral stricture, hematuria, or proctitis occurred in 2.8%, 0%, and 0%, respectively.</div></div><div><h3>CONCLUSION</h3><div>HDR brachytherapy in addition to EBRT is effective treatment for unfavourable localized prostate cancer with a very acceptable toxicity profile. The biochemical definition of cure of PSA &lt; 0.2 ng/mL at 4 years was predictive for FFS at 9 years.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 318-327"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Escalating the dose of high-dose-rate brachytherapy combined with external beam radiotherapy improves the disease control rate in patients with high- or very-high-risk prostate cancer","authors":"Takaya Inagaki ,&nbsp;Yasutaka Noda ,&nbsp;Yuya Iwahashi ,&nbsp;Takahiro Naka ,&nbsp;Maria Kojima ,&nbsp;Riki Inagaki ,&nbsp;Ryuki Shimono ,&nbsp;Azusa Awaya ,&nbsp;Yasuo Kohjimoto ,&nbsp;Isao Hara ,&nbsp;Tetsuo Sonomura","doi":"10.1016/j.brachy.2024.10.011","DOIUrl":"10.1016/j.brachy.2024.10.011","url":null,"abstract":"<div><h3>PURPOSE</h3><div>High-dose-rate brachytherapy (HDR-BT) combined with external beam radiotherapy (EBRT) is an effective treatment for patients with high- and very-high-risk prostate cancer. We sought to identify the factors associated with reduced biochemical recurrence rates following HDR-BT.</div></div><div><h3>METHODS</h3><div>A total of 304 patients with high- or very-high-risk prostate cancer who underwent HDR-BT and EBRT were analyzed. EBRT comprised 50 Gy in 25 fractions and HDR-BT comprised 18 Gy in 2 fractions. Biochemical recurrence was defined as an increase in prostate specific antigen (PSA) by ≥2.0 ng/mL from the nadir level.</div></div><div><h3>RESULTS</h3><div>The median follow-up time was 8.2 years (range, 3.4‒13.7 years) after HDR-BT. The 5-year biochemical progression-free survival (bPFS), overall survival, and cause-specific survival rates were 87.4%, 93.3%, and 100%, respectively. In univariate and multivariable analyses, a biologically effective dose (α/β = 1.5) ≥ 240 Gy and androgen deprivation therapy (ADT) were significantly associated with better bPFS (<em>p</em> = 0.020 and 0.007, respectively), whereas pretreatment PSA ≥ 40 ng/mL and Gleason score group 5 were significantly associated with worse bPFS (<em>p</em> = 0.080 and 0.021, respectively). Grade ≥ 3 rectal toxicities occurred in 0.3% of patients and grade ≥ 3 urinary toxicities occurred in 3.4% of patients.</div></div><div><h3>CONCLUSION</h3><div>In patients with high- and very-high-risk prostate cancer treated with EBRT and HDR-BT, dose escalation and ADT were associated with improved tumor control. By comparison, Gleason score group 5 and pretreatment PSA &gt;40 ng/mL were associated with worse tumor control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 223-230"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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","authors":"Silvia Rodríguez Villalba ,&nbsp;Diana Guevara Barrera ,&nbsp;Luis Suso-Martí ,&nbsp;Enrique Sanchis-Sánchez ,&nbsp;Jose Pérez-Calatayud ,&nbsp;Jose Domingo Lago Martín ,&nbsp;Francisco Blázquez Molina ,&nbsp;Manuel Santos Ortega","doi":"10.1016/j.brachy.2024.10.014","DOIUrl":"10.1016/j.brachy.2024.10.014","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the outcomes of patients treated for low-risk (LR) and favorable intermediate risk (FIR) prostate cancer with brachytherapy (BT) in monotherapy with LDR or HDR and its relationship with nadir PSA (nPSA).</div></div><div><h3>Materials and Methods</h3><div>We retrospectively analyzed 139 patients (2005-2019) with exclusive LDR (46%. 145/160 Gy) /HDR (54%. 2 implants of 13.5 Gy each separated 10 days). 69% LR and 31% FIR. PSA nadir was grouped into two categories: ≤ 0.2 ng/mL and &gt; 0.2 ng/mL.</div></div><div><h3>Results</h3><div>Median patient age was 69 years (46-84). Seventy-six patients (55%) received androgen deprivation therapy, and 37% received neoadjuvant therapy. Median follow-up period was 90 months. Actuarial biochemical failure-free survival (BFFS), local control (LC), overall survival (OS), and cause-specific survival (CSS) rates for the total cohort were 78%, 87%, 68%, and 98% at 10 years, respectively. BFFS, LC, OS and CSS in nPSA ≤ 0,2 ng/ml was 90%, 96%, 67%, 100% at 10 years respectively, whereas, those with a nPSA &gt; 0.2 ng/ml had a BFFS, LC, OS and CSS of was 37%, 51%, 72%, 90% at 10 years respectively Statistical significance between both groups was reached in BFFS (p=0,000), LC (p=0,000) and CSS (p=0,007)). In the univariate analysis, there was no difference between risk stratification, BT technique, ADT, or the development of bouncing.</div></div><div><h3>Conclusions</h3><div>Prostate brachytherapy as monotherapy (LDR and HDR) is an effective treatment option for patients with LR and FIR prostate cancer. nPSA ≤0,2 ng/ml is a representative value that provides prognostic information for favorable outcomes in this group of patients.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 310-317"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824928","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":"Transition from point A to volume based image guided brachytherapy across a network of centers in India through workshop and mentoring","authors":"Harjot Kaur Bajwa ,&nbsp;Manikumar Singamsetty ,&nbsp;Mohan Lal ,&nbsp;Manjinder Singh Sidhu ,&nbsp;Sumeet Aggarwal ,&nbsp;Ritu Agarwal ,&nbsp;Midhun Murali ,&nbsp;Dhanya K S ,&nbsp;Rajesh Natte ,&nbsp;Suresh Chaudhari ,&nbsp;Vibhor Gupta ,&nbsp;Sushil Beriwal","doi":"10.1016/j.brachy.2024.11.005","DOIUrl":"10.1016/j.brachy.2024.11.005","url":null,"abstract":"<div><h3>AIM</h3><div>To demonstrate how workshop and mentoring across a network of radiotherapy centers helped in transitioning from point A to volume-based image guided brachytherapy in carcinoma cervix.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Based on discussion with different centers across the network, the lapses in cervical cancer treatment were identified and a workshop was designed to change the practice pattern. The main focus of the workshop was to streamline EBRT dose prescription protocols and implement volume based image guided brachytherapy through mentoring and hands on training. Patient data was analyzed 1 year post workshop to assess the impact in changing practice pattern.</div></div><div><h3>RESULTS</h3><div>A total of 246 cervical cancer patients treated with radical chemo radiotherapy and image guided brachytherapy were analyzed. 207 patients received CT based intracavitary brachytherapy whereas 39 patients received MR based hybrid brachytherapy. In patients who received EBRT and brachytherapy at the same center, the EBRT prescription dose was 45Gy in 25 fractions in 95% patients. The mean dose received by 90% of the HRCTV was 80.8Gy EQD2 in CT based intracavitary brachytherapy and 89.48Gy EQD2 in MR based hybrid brachytherapy. The mean bladder, rectum, sigmoid and small bowel D2cc doses were 63.87Gy, 62.18Gy, 61.2Gy and 55.1Gy EQD2 respectively.</div></div><div><h3>CONCLUSION</h3><div>This report demonstrates successful implementation and change of carcinoma cervix treatment practice pattern through workshop and mentoring across a network of radiotherapy centers in India.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 348-353"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901216","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":"Haralick texture feature analysis for Monte Carlo dose distributions of permanent implant prostate brachytherapy","authors":"Iymad R. Mansour ,&nbsp;Nelson Miksys ,&nbsp;Luc Beaulieu ,&nbsp;Éric Vigneault ,&nbsp;Rowan M. Thomson","doi":"10.1016/j.brachy.2024.08.256","DOIUrl":"10.1016/j.brachy.2024.08.256","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Demonstrate quantitative characterization of 3D patient-specific absorbed dose distributions using Haralick texture analysis, and interpret measures in terms of underlying physics and radiation dosimetry.</div></div><div><h3>METHODS</h3><div>Retrospective analysis is performed for 137 patients who underwent permanent implant prostate brachytherapy using two simulation conditions: “TG186” (realistic tissues including 0–3.8% intraprostatic calcifications; interseed attenuation) and “TG43” (water-model; no interseed attenuation). Five Haralick features (homogeneity, contrast, correlation, local homogeneity, entropy) are calculated using the original Haralick formalism, and a modified approach designed to reduce grey-level quantization sensitivity. Trends in textural features are compared to clinical dosimetric measures (D90; minimum absorbed dose to the hottest 90% of a volume) and changes in patient target volume % intraprostatic calcifications by volume (%IC).</div></div><div><h3>RESULTS</h3><div>Both original and modified measures quantify the spatial differences in absorbed dose distributions. Strong correlations between differences in textural measures calculated under TG43 and TG186 conditions and %IC are observed for all measures. For example, differences between measures of contrast and correlation increase and decrease respectively as patients with higher levels of %IC are evaluated, reflecting the large differences across adjacent voxels (higher absorbed dose in voxels with calcification) when calculated under TG186 conditions. Conversely, the D90 metric is relatively weakly correlated with textural measures, as it generally does not characterize the spatial distribution of absorbed dose.</div></div><div><h3>CONCLUSION</h3><div>Patient-specific 3D dose distributions may be quantified using Haralick analysis, and trends may be interpreted in terms of fundamental physics. Promising future directions include investigations of novel treatment modalities and clinical outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 122-133"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of MRI-based planning in transperineal interstitial brachytherapy for locally advanced cervix tumors: Clinical, dosimetric and toxicity outcomes","authors":"Diana Guevara Barrera ,&nbsp;Silvia Rodríguez Villalba ,&nbsp;Luis Suso-Martí ,&nbsp;Enrique Sanchis-Sánchez ,&nbsp;Jose Perez-Calatayud ,&nbsp;Jose Domingo Lago Martín ,&nbsp;Francisco Blázquez Molina ,&nbsp;Manuel Santos Ortega","doi":"10.1016/j.brachy.2024.10.005","DOIUrl":"10.1016/j.brachy.2024.10.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To compare dosimetric characteristics, clinical outcomes, and toxicity in patients with locally advanced cervical cancer(LACC) treated with transperineal interstitial brachytherapy(P-ISBT), using CT-based planning or MRI-based planning with a monoinstitutional MRI-compatible applicator, Template Benidorm(TB).</div></div><div><h3>MATERIALS AND METHODS</h3><div>We retrospectively analyzed 106 women treated with P-ISBT for LACC from 2006 to 2022. P-ISBT was CT-based, with Martinez Universal Perineal Interstitial Template(MUPIT) between 2006 and 2012, or MRI-based planning (TB) since 2013. Volumetric, clinical, and dosimetric parameters were compared between applicators.</div></div><div><h3>RESULTS</h3><div>Forty-six (43.4%) patients were treated with MUPIT, and 60 (56.6%) with TB. Median follow-up was 42 months (4–188). No significant difference was observed in 5-year local control (LC), regional control (RC), distant failure (DF), overall survival (OS), and disease-specific survival (DSS) between applicators. The TB cohort had fewer needles (<em>p = 0.001</em>), halved median CTV volume (<em>p &lt; 0.001</em>), increased median D_90%CTV dose (<em>p &lt; 0.005</em>), and lower D_2cc values in rectum/bladder (<em>p &lt; 0.001</em>). G3 chronic toxicity was 15% in the MUPIT group and 6% in TB (<em>p = 0.15</em>), with no G4 toxicity reported. Rectal hemorrhage was lower in the TB group (<em>p = 0.002</em>). Larger CTV volumes correlated with higher rectal D2cc and rectal hemorrhage (<em>p = 0.001; p = 0.029</em>, respectively), and enterovaginal fistula (<em>p = 0.03; p &lt; 0.001</em>, respectively). Median CTV volume was 152.82 cc (35.3–256.78) in patients with chronic rectal toxicity and 102.9 cc (21.4–329.41) in those without (<em>p = 0.001</em>).</div></div><div><h3>CONCLUSION</h3><div>MRI's superior CTV-volume definition results in smaller treatment volumes, lower D_2cc for rectum and bladder, and a trend towards higher CTV D_90%. Rectal hemorrhage was significantly lower in the MRI-based group. A significant correlation was observed between larger CTV-volumes, higher rectal D_2cc and rectal hemorrhage/enterovaginal fistula.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 134-143"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647791","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}