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• W2091245133 abstract "RTOG 0321 is the first and only cooperative group prospective HDR prostate brachytherapy trial. It is the only such trial with complete digital brachytherapy dosimetry data. This is a detailed descriptive report of the dosimetric parameters and an analysis of acute toxicity. Patients were treated with external beam radiotherapy 45 Gy in 25 fractions and one HDR implant with prescribed dose of 19 Gy in 2 fractions. Implants were done with TRUS guidance using CT-compatible non-metallic catheters. HDR planning was done on ≤3 mm thick CT slices. Plans were submitted to the Image-Guided Therapy Center (ITC). The “mean DVH” of the PTV, implanted volume, and OAR were calculated. This included the mean, upper, lower, 99%, and 95% confidence intervals, which corresponded to approximately 1 and 2 SDs of the volume at 10 percentage point intervals from 10% to 200% of the prescribed dose. The conformal index (COIN), homogeneity index (HI), number of catheters/implant, and number of patients per institution were collected. Multivariate analysis and calculation of odds ratios (OR) of all the variables against reported Grade ≥2 (G2+) GU and GI adverse events (AE) were performed. Dosimetry data were based on 121 eligible patients (129 enrolled) with complete data from 14 institutions. The mean (range) of PTV, implanted volume, catheters/implant, and patients/institution were: 51 cc (16 – 123), 63 cc (26 – 147), 19 (13 – 29), and 9 cc (2 – 19), respectively. The mean (range) of %V100PTV, V80Bladder, V80Rectum, V120Urethra, COIN and HI were: 94% (87 – 99), 0.40 cc (0 – 3.2), 0.15 cc (0 – 1.1), 0.25 cc (0 – 1.1), 0.75 cc (0.49 – 0.87), and 0.63 cc (0.39 – 0.85), respectively. There were too few G2+ GI AEs for correlative analysis, so the analysis was performed on G2+ GU AE only. There were 33 G2 and 3 G3 AEs. There were positive correlations between G2+ GU AEs and urethral dose at multiple dose levels, most significantly at V120Urethra (OR, 8.66; CI, 2.2 – 33; p = 0.002), and negative correlation between AE and HI (OR, 0.001; CI, <0.001 – 0.30; p = 0.01). The institution with highest accrual rate had the lowest rate of G2+ GU AE (p = 0.006). Higher urethral doses and lower dose homogeneity correlated with greater treatment-related toxicities. Correlations at multiple dose levels suggest multiple urethral dose constraints may be needed to further lower AE. A mean DVH comparison at all dose levels should be used for quality control and future research comparison." @default.
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• W2091245133 date "2011-10-01" @default.
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• W2091245133 title "Prostate HDR Dosimetric Parameters and Treatment Related Toxicity in the Radiation Therapy Oncology Group (RTOG) 0321" @default.
• W2091245133 doi "https://doi.org/10.1016/j.ijrobp.2011.06.027" @default.
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