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• W2344990504 abstract "Low-dose-rate brachytherapy typically relies on a loose or stranded isotope whose dosimetry is characterized as point sources. A polymer-encapsulated 103Pd source with a unique linear radioactive distribution may provide a useful refinement on prostate brachytherapy. A feasibility study was performed in a small cohort to assess the pre- and postimplant dosimetry trends, the ease and efficiency of use, and the patient side effects. The number of needles required for adequate coverage was a primary endpoint, with secondary endpoints including full dosimetry parameters, active length of source, and reported ease of use. With institutional review board approval, volunteers with early prostate cancer were implanted at one of two centers. Implants were preplanned using brachytherapy treatment planning software. Implantation was performed using needles preloaded with palladium strings as ordered at one of two centers: Arizona (AZ) or New York (NY). The planned prescription dose was 125 Gy for monotherapy and 100 Gy when given as a boost. Postimplant dosimetry was performed based on computed tomography (CT) images obtained at 3 to 6 weeks and are reported in percentages to account for differences between boost and monotherapy prescription doses. Fourteen patients gave consent and implants were planned. Six AZ implants were prescribed to 125 Gy; 7 NY implants were prescribed to 100 Gy; and 1 case cancelled prior to implant. The number of planned needles and prostate sizes ranged from 15 to 25 and 20 to 100 mL, respectively. Nine of 13 cases required 17 or fewer needles. Planned source activity ranged from 2.8 to 3.9 U/cm. For monotherapy, the total activity ranged from 129.5 to 261.8U; for boost, activity ranged from 92.4 to 244.8U. This allows for the generation of a nomogram for this line source at both prescription dose levels which will be presented. Planning was consistent between centers with mean D90% and V150%, 124% and 66% (AZ) and 126% and 78% (NY). One month postimplant dosimetry was available for 10 patients. The ratio of postimplant/preplan prostate volume ranged from 0.82 to 1.36 (median 1.05). For a dose of 100 Gy, the postimplant D90 ranged from 99% to 128% (median 108.9%). For a dose of 125 Gy, the postimplant D90 ranged from 81% to 121% (median 99.8%). An initial experience with this new line source is presented. Excellent implants across a range of gland sizes were accomplished. Prostate volume changes were minimal suggesting minimal swelling using the chosen needles and strands. Good dosimetry is achieved for both preplans and eventual implants. Using a line source, the number of needles required per patient is less than that reported with standard brachytherapy sources. Intraoperative ease of use is good. With a line source, fewer needles are required but follow-up is ongoing for this study to determine if there are clinical benefits." @default.
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• W2344990504 date "2015-11-01" @default.
• W2344990504 modified "2023-09-25" @default.
• W2344990504 title "First Report of a New 103PD Line Source for Prostate Brachytherapy" @default.
• W2344990504 doi "https://doi.org/10.1016/j.ijrobp.2015.07.1065" @default.
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