Salvage of suboptimal prostate seed implantation: Reimplantation of underdosed region of prostate base.

Purpose: To demonstrate how a suboptimal (125)I prostate implant can be salvaged by reimplantation.

Methods And Materials: A (125)I implant was preplanned to deliver 150 Gy to the prostate of a patient with early stage prostate cancer. A CT scan at 35 days postimplant indicated that V(100) and D(90) were 46% and 49 Gy, respectively.

Factors predicting for urinary incontinence after prostate brachytherapy.

Purpose: To define risk factors that predict for urinary incontinence after (125)I prostate brachytherapy.

Methods And Materials: Urinary incontinence after (125)I prostate brachytherapy was evaluated using a patient self-assessment questionnaire based on the NCI Common Toxicity Criteria (version 2). Grade 0 is defined as no incontinence; Grade 1 incontinence occurs with coughing, sneezing, or laughing; Grade 2 is spontaneous incontinence with some control; and Grade 3 is no control.

A detailed examination of the difference between planned and treated margins in 125I permanent prostate brachytherapy.

Purpose: To determine whether potential extraprostatic extension (EPE) of prostate adenocarcinoma is covered by the prescribed dose when permanent 125I implants are planned with a 5-mm treatment margin.

Methods And Materials: The postimplant dosimetry of 60 consecutive 125I prostate implants was analyzed to determine whether there was a residual 3-mm margin, adequate for treatment of potential EPE. The implants were peripherally loaded and planned with a nominal 5-mm symmetric dose margin.

Is it necessary to eliminate the posterior dose margin in prostate brachytherapy to achieve an acceptably low risk of late rectal morbidity?

Purpose: The use of a posterior dose margin in (125)I prostate brachytherapy is controversial. The posterior margin is often eliminated to lower the risk of late rectal morbidity (Radiation Therapy Oncology Group protocols 9805 and P-0019), but this may compromise the posterior prostate dose coverage. The purpose of this work is to determine whether it is necessary to eliminate the posterior margin to achieve an acceptably low risk of Grade 2 (bleeding/ulceration) late rectal morbidity.

Cholangiocarcinoma: the impact of tumor location and treatment strategy on outcome.

The purpose of this study was to evaluate how the outcome of patients with extrahepatic cholangiocarcinoma (EHBC) may have been influenced by tumor location and treatment selection. The primary endpoint of this study is overall survival (OS). Between January 1983 and December 1997, 221 patients with biliary tumors were evaluated at Thomas Jefferson University Hospital.

Impact of oedema on implant geometry and dosimetry for temporary high dose rate brachytherapy of the prostate.

The optimal timing of dosimetry for permanent seed prostatic implants remains contentious given the half life of post-implant oedema resolution. The aim of this study was to establish whether prostatic oedematous change over the duration of a temporary high dose rate (HDR) interstitial brachytherapy (BR) boost would result in significant needle displacement, and whether this change in geometry would influence dosimetry. Two CT scans, one for dosimetric purposes on the day of the implant and the second just prior to implant removal, were obtained for four patients receiving transperineal interstitial prostate brachytherapy.

Probability of late rectal morbidity in 125I prostate brachytherapy.

Purpose: Rectal toxicity is a concern in prostate brachytherapy because it is difficult to avoid delivering a dose equal to, or greater than, the prescription dose to the anterior surface of the rectum. The purpose of this study was to define the probability that a patient will experience Grade 2 (bleeding/ulceration) late rectal morbidity after 125I prostate brachytherapy according to the rectal dosimetry.

Methods And Materials: Ninety-eight consecutive patients who received monotherapy 125I prostate implants for treatment of Stage T1-T2, favorable-risk adenocarcinoma of the prostate were evaluated for Radiation Therapy Oncology Group Grade 2 late rectal morbidity.

Impact of postimplant edema on V(100) and D(90) in prostate brachytherapy: can implant quality be predicted on day 0?

Purpose: To determine the effect of edema on the dosimetric parameters V(100) (percentage of prostate volume that received a dose equal to or greater than the prescribed dose) and D(90) (minimal dose delivered to 90% of prostate volume) in 125I prostate brachytherapy and to determine whether the edema can be used to predict implant quality on the day of the implant (Day 0).

Methods And Materials: Fifty consecutive patients treated with (125)I implants who had two postimplant CT scans were selected for this study. The mean interval between the studies was 46 +/- 23 days.