TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY
|
|
- Darrell Barker
- 5 years ago
- Views:
Transcription
1 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 1 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY BRENDAN CAREY, MD
2 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 2 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY DR. BRENDAN CAREY, CONSULTANT RADIOLOGIST, ST JAMES INSTITUTE OF ONCOLOGY, LEEDS, UK Modern prostate brachytherapy has been established over the past three decades as an effective treatment for localized prostate cancer with high patient tolerability and acceptable morbidity outcome data. With transrectal ultrasound (TRUS)-guided brachytherapy, radiation is delivered directly into the gland. This allows for intra-prostatic doses of radiation that are unachievable by external beam radiation therapy (EBRT) techniques alone with the potential convenience of a single-day outpatient procedure. Prostate brachytherapy can be delivered in two different ways: permanent seed implants using iodine or palladium seeds (Low Dose Rate, or LDR) or using temporary removable implants with iridium wires (High Dose Rate, or HDR). Biplane transrectal ultrasound is essential for accurate imaging guidance to place the radioactive sources into the prostate using a template-guided transperineal technique. TRUS technology and radiation planning software continue to evolve, and selection criteria for prostate brachytherapy in terms of patient selection, treatment planning, treatment technique, post-implant evaluation, and biochemical and quality-of-life outcomes have been established and published. INTRODUCTION Prostate cancer interventions have been greatly facilitated by developments in ultrasound transducer design and technology. Radiotherapy for prostate cancer can be delivered in different ways: conventionally, using external beam techniques, or by implanting the radioactive sources directly into the prostate (brachytherapy). The role of various ablation techniques including brachytherapy as an alternative to radical prostatectomy or EBRT techniques for the definitive treatment of prostate cancer have gained in popularity. The modern era of prostate brachytherapy began in the 1980 s with the development of the closed transperineal implant technique using transrectal ultrasound guidance. Transrectal ultrasound guidance facilitates a closed percutaneous transperineal approach to the prostate for placement of radioactive sources. The development of biplane transrectal ultrasound transducer technology, like BK Medical s endocavity biplane transducer, 8848, has improved the safety and accuracy of the technique and the outcome data over recent years has confirmed that it is an effective treatment with high patient tolerance and acceptable morbidity. There is growing comprehensive evidence on the excellent clinical outcome after prostate brachytherapy. Advances in diagnostic imaging and TRUS-guided biopsy techniques have the potential for more accurate localization of cancers within the prostate, and there is growing interest in the concept of focal therapies driven by downward stage migration, improved biopsy and imaging techniques, and the prevalence of unifocal dominant cancers. Focal prostate brachytherapy is being explored as a future treatment option for clinically localized prostate cancer.
3 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 3 Prostate brachytherapy is a valid alternative to radical prostatectomy and external beam radiotherapy for localized prostate cancer. The exact choice of brachytherapy technique will vary depending on the stage of the prostate cancer and disease-specific parameters such as the Serum PSA at presentation and the Gleason Score from the prostate biopsy. LDR Brachytherapy is performed with permanent implantation of radioactive seeds into the prostate, usually iodine-125 with a half life of 60 days, although palladium-103 sources with a half life of 17 days can also be used. HDR Brachytherapy uses temporary placement of iridium wires into the prostate, and these are then removed after the treatment is completed. Whatever technique is used, the transrectal ultrasound procedure is similar: the prostate is scanned to obtain an accurate volume and shape, and this information is used by the radiation planning software such as the Varian system to generate a 3-dimensional dose plan for each patient. Prostate brachytherapy is a valid alternative to radical prostatectomy and external beam radiotherapy for localized prostate cancer. The ultrasound data collected from this pre-treatment volumetric assessment is the basis for calculating the required number and location of sources for that particular patient and consists of both prostate volume acquisition and accurate 3D volume-rendered dosimetry. The radioactive sources are then inserted, transperineally, into the gland using a template-guided technique under real-time biplane ultrasound guidance, for which the BK Medical biplane transducer 8848 together with the Flex Focus system are ideally suited. Brachytherapy techniques have evolved since the original Seattle 2-step technique for LDR brachytherapy. More sophisticated TRUS and treatment planning software have been introduced and seem to have a significant impact on the accuracy of source placement and on ultrasound-based dosimetry. Whatever technique is used, the TRUS set-up is similar and general principles apply. TRANSRECTAL ULTRASOUND SETUP The procedure is performed in the operating room with the patient in the dorsal lithotomy position. General anaesthesia is generally used although, occasionally, spinal anaesthesia may be utilized. An inflatable (water)standoff probe cover can be used with the biplane transducer 8848 to facilitate elevation and optimum access for source positioning within the prostate gland during implantation. The TRUS transducer is positioned in a stepping device that allows the prostate to be scanned systematically in both axial and sagittal planes. 1 TRUS setup for Brachytherapy with 5mm grid overlay. 2 Biplanar imaging to monitor source placement in prostate.
4 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 4 The bladder may be catheterized, and radiographic contrast can be introduced into the bladder to facilitate fluoroscopy of the bladder base. Aerated ultrasound gel or a urethral catheter can also be used to delineate the urethra and aid urethral recognition during implantation. An implant grid, mounted onto the stepping unit, is placed against the perineum to guide needle and source placement within the prostate. This implant grid is calibrated to an on-screen superimposition of the grid matrix over the ultrasound image (Fig. 1). Advanced software in the BK Medical ultrasound system permits very accurate volume and surface outline calculations of the prostate and seminal vesicles. The software also includes a matrix offset and a user-defined option which can be programmed to compensate for any non-standard matrix. The transducer can be used for seed implantation with a choice of specially designed brachytherapy matrix templates. Using the ultrasound data, the requisite number and distribution of radioactive sources is calculated for the patient. The Brachytherapy Pro Package with the ultrasound system contains all the essential setups and measurements for precise volumetric assessment of the prostate gland, simultaneous biplane imaging and tissue harmonic imaging. 3-dimensional imaging also facilitates assessment of the gland during implantation. Biplane ultrasound with the endocavity transducer 8848 allows each needle to be monitored as it is inserted transperineally into the prostate. The sources are then loaded into the prostate, through these needles, under direct, real-time ultrasound guidance (Fig. 2). Great care must be taken to avoid inadvertent trauma to the bladder, urethra and rectum during insertion. Biplane ultrasound with the transducer 8848 greatly facilitates identification of needle and source deposition in the prostate and enhances the development of these newer implantation modifications. LDR BRACHYTHERAPY LDR brachytherapy is most frequently used in low-risk patients. The original Seattle 2-step technique has stood the test of time in terms of outcomes, but in recent years intraoperative-planned techniques have emerged in an effort to overcome some of the acknowledged limitations of the pre-planned technique. The specific aims are to design the optimal treatment plan using intraoperative 3D anatomical information, to implement the treatment plan with precision, and to analyze the dosimetric outcome while the procedure is still in progress. 3 3D imaging to monitor needle and source placement during implant. 4 Post-implant image showing HDR source location in prostate.
5 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 5 This offers the opportunity to improve the quality of implants by appropriate modification in the seed implants and replanning during the procedure itself (Fig. 3). Inverse-radiation planning optimization techniques for optimal seed placement, 3D ultrasound technology with real-time needle guidance are some examples of technological improvements already used in LDR brachytherapy. Based on the volume of the prostate, generally between 70 and 150 radioactive seeds are preloaded into needles and inserted into the prostate. The seeds are deployed into the gland and the needles are then removed. The seeds remain in the prostate permanently, with radioactive decay times of 60 days for iodine-125 and for 17 days for palladium-103. During this time, the patient must observe basic but minimal radiation precautions. Travel and contact with adults are not restricted; however, small children and pregnant women should not be in direct prolonged contact with the patient during this period. Sexual intercourse can usually be resumed after about one month. Most patients will experience some urinary symptoms after prostate brachytherapy, and acute urinary retention generally occurs in about 15% of patients following LDR brachytherapy. Nocturia and daytime frequency are very common, and overall urinary morbidity does correlate with higher pre-treatment International Prostate Symptom Score (IPSS) urinary scores. The relationship between urethral dose and urinary toxicity is unclear, although most patients benefit from routine use of alpha blockers (smooth muscle relaxants) during the initial weeks after implantation. Prolonged urinary catheterization is unusual, and surgery to improve urinary flow should be avoided, if at all possible, as it has a high risk of causing incontinence afterwards. Rectal complications are uncommon and usually consist of self-limited proctitis. Long-term bowel dysfunction after brachytherapy is very unusual. Preservation of sexual function after brachytherapy, as with other prostate cancer treatments, is difficult to assess. There seems to be no clear evidence so far for factors influencing erectile dysfunction after brachytherapy. HDR BRACHYTHERAPY In patients with intermediate and high-risk prostate cancers, there is increasing dosimetric and clinical evidence for the efficacy of HDR prostate brachytherapy. This can be delivered as a radiation boost combined with external beam radiotherapy or as monotherapy. Combined HDR brachytherapy and EBRT is used for patients with locally more advanced disease those with higher PSA levels or higher pathology (Gleason 8-10) grade. HDR brachytherapy permits delivery of a large radiation dose to the prostate in a small number of treatment doses (fractions). The setup implant technique itself is identical to that for LDR: under TRUS guidance and using a template transperineal technique, up to 20 blind-ended needles are inserted into the prostate (Fig. 4). Source dwell positions and times are determined using specialist planning software, and the radiation treatment is delivered using a single iridium source via an afterloading unit. Following treatment, the needles and source are removed, and once haemostasis is achieved, the urinary catheter is also removed. Acutely, HDR brachytherapy commonly leads to an increase in urinary symptoms. However, this is generally short lived, and catheterisation is rarely needed. Acute and late rectal toxicity rates are low following HDR brachytherapy. CONCLUSION Prostate brachytherapy has become a widely accepted and valid method for the treatment of localized prostate cancer. Implant techniques continue to evolve and future options will include focal brachytherapy. Biplane transrectal ultrasound guidance, enabled by the BK Medical 8848 transducer and ultrasound system with its specially designed Brachytherapy Pro Package software and fully integrated 3D capabilities, greatly assists the safety and accuracy of the procedure.
6 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 6 FLEX FOCUS FOR ULTRASOUND GUIDANCE Our BK products are the market leaders for ultrasound-guided brachytherapy. We lead the field because we have dedicated development resources specifically to ultrasound-guided brachytherapy and have built up strong ties with the leading providers of brachytherapy seeds to the advantage of our customers who can purchase a complete brachytherapy package for the prostate. The 8848 transducer delivers confidence in precise prostate brachytherapy. Simultaneous biplane imaging (sagittal and transverse view), provides better orientation during needle placement and greater confidence in source placement in the prostate gland. Endocavity Biplane (8848)during implant. Flex Focus Endocavity Biplane (8848) scanning planes
7 TRANSRECTAL ULTRASOUND-GUIDED PROSTATE BRACHYTHERAPY 7 This ebook is distributed by BK Ultrasound. Please visit us at: bkultrasound.com/applications/urology REFERENCES 1. Holm H, Juul N, Pederson J, et al. Transperineal I 125 seed implantation in prostatic cancer guided by transrectal ultrasoundography. J Urology 1983; 130: Morton G, Loblaw A, Cheung P, et al. Is single fraction 15Gy the preferred high dose-rate brachytherapy boost dose for prostate cancer? Radiother Oncol. 2011;100: Morton GC, Loblaw DA, Chung H, et al. Health-Related Quality of Life After Single-Fraction High-Dose-Rate Brachytherapy and Hypofractionated External Beam Radiotherapy for Prostate Cancer. Int J Radiat Oncol Biol 4. Pellizzon AC, Nadalin W, Salvajoli JV, et al. Results of high dose rate afterloading brachytherapy boost to conventional external beam radiation therapy for initial and locally advanced prostate cancer. Radiother Oncol 2003;66: Henry A, Al-Qaisieh B, Gould K, et al. Outcomes following iodine-125 monotherapy for localized prostate cancer: the results of Leeds 10-year single-center brachytherapy experience. Int J Radiat Oncol Biol Phys 2010;76: Hinnen K, Battermann J, van Roermund J, et al. Long-term biochemical and survival outcome of 921 patients treated with I-125 permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys 2010;76: Prada P, Juan G, Gonzalez-Suarez H, et al. Prostate-specific antigen relapse-free survival and side-effects in 734 patients with up to 10 years of follow-up with localized prostate cancer treated by permanent iodine implants. BJU Int 2010;106: Sylvester J, Grimm P, Wong J, et al. Fifteen-year biochemical relapse-free survival, cause-specific survival, and overall survival following I(125) prostate brachytherapy in clinically localized prostate cancer: Seattle experience. Int J Radiat Oncol Biol Phys 2011;81: Demanes D, Martinez A, Ghilezan M, et al. High-dose-rate monotherapy: safe and effective brachytherapy for patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 2011;81: Ash D, Al-Qaisieh B, Gould K, et al. Long term outcomes following iodine-125 monotherapy for localized prostate cancer: the Cookridge 10 year results. Clin Oncol (R Coll Radiol) 2007; S Kovacs G, Potter R, Loch T, et al. EC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer. Radiother Oncol 2005; 74(2): Polo A, Salembier C, Venselaar J, et al. Review of intraoperative imaging and planning techniques in permanent seed prostate brachytherapy. Radiother Oncol 2010; 94(1): Lubbe W, Cohen R, Sharma N, et al. Biochemical and clinical experience with real-time intraoperatively planned permanent prostate brachytherapy. Brachytherapy 2012; 11(3):
20 Prostate Cancer Dan Ash
20 Prostate Cancer Dan Ash 1 Introduction Prostate cancer is a disease of ageing men for which the aetiology remains unknown. The incidence rises up to 30 to 40% in men over 80. The symptoms of localised
More informationARTICLE. The current role of imaging for prostate brachytherapy
Cancer Imaging (2007) 7, 27 33 DOI: 10.1102/1470-7330.2007.0003 ARTICLE The current role of imaging for prostate brachytherapy Brendan Carey and Sarah Swift Radiology Department, Cookridge Hospital, Leeds,
More informationMEDICAL POLICY. SUBJECT: BRACHYTHERAPY OR RADIOACTIVE SEED IMPLANTATION FOR PROSTATE CANCER POLICY NUMBER: CATEGORY: Technology Assessment
MEDICAL POLICY SUBJECT: BRACHYTHERAPY OR PAGE: 1 OF: 5 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy
More informationTrina Lynd, M.S. Medical Physicist Lifefirst Imaging & Oncology Cullman, AL Tri-State Alabama, Louisiana and Mississippi Spring 2016 Meeting April
Trina Lynd, M.S. Medical Physicist Lifefirst Imaging & Oncology Cullman, AL Tri-State Alabama, Louisiana and Mississippi Spring 2016 Meeting April 17, 2016 Discuss permanent prostate brachytherapy and
More informationLDR prostate brachytherapy
LDR prostate brachytherapy Introduction Low dose rate (LDR) prostate brachytherapy is a modern, effective minimally invasive treatment appropriate for many men with early prostate cancer. I perform this
More informationRadiation Therapy for Prostate Cancer. Resident Dept of Urology General Surgery Grand Round November 24, 2008
Radiation Therapy for Prostate Cancer Amy Hou,, MD Resident Dept of Urology General Surgery Grand Round November 24, 2008 External Beam Radiation Advances Improving Therapy Generation of linear accelerators
More informationMEDICAL POLICY SUBJECT: BRACHYTHERAPY OR RADIOACTIVE SEED IMPLANTATION FOR PROSTATE CANCER
MEDICAL POLICY SUBJECT: BRACHYTHERAPY OR PAGE: 1 OF: 6 If the member's subscriber contract excludes coverage for a specific service it is not covered under that contract. In such cases, medical policy
More informationDOSIMETRIC OPTIONS AND POSSIBILITIES OF PROSTATE LDR BRACHYTHERAPY WITH PERMANENT I-125 IMPLANTS
DOSIMETRIC OPTIONS AND POSSIBILITIES OF PROSTATE LDR BRACHYTHERAPY WITH PERMANENT I-125 IMPLANTS Andrius IVANAUSKAS*, Eduardas ALEKNAVIČIUS*, Arvydas BURNECKIS*, Albert MILLER *Institute of Oncology Vilnius
More informationThe benefit of a preplanning procedure - view from oncologist. Dorota Kazberuk November, 2014 Otwock
The benefit of a preplanning procedure - view from oncologist Dorota Kazberuk 21-22 November, 2014 Otwock Brachytherapy is supreme tool in prostate cancer management with a wide range of options in every
More informationPROSTATE CANCER BRACHYTHERAPY. Kazi S. Manir MD,DNB,PDCR RMO cum Clinical Tutor Department of Radiotherapy R. G. Kar Medical College
PROSTATE CANCER BRACHYTHERAPY Kazi S. Manir MD,DNB,PDCR RMO cum Clinical Tutor Department of Radiotherapy R. G. Kar Medical College Risk categorization Very Low Risk Low Risk Intermediate Risk High Risk
More informationHealthcare Professional Guide
Healthcare Professional Guide Brachytherapy: The precise answer for tackling prostate cancer Because life is for living Radiotherapy: a cornerstone of prostate cancer care Prostate cancer is the most commonly
More informationCLINICAL WORKSHOP IMAGE-GUIDED HDR BRACHYTHERAPY OF PROSTATE CANCER
CLINICAL WORKSHOP IMAGE-GUIDED HDR BRACHYTHERAPY OF PROSTATE CANCER Klinikum Offenbach Nucletron April 27 th 28 th, 2014 History HDR Protocols for Boost and Monotherapy, Results, Logistics and Practical
More informationQuality Assurance of Ultrasound Imaging in Radiation Therapy. Zuofeng Li, D.Sc. Murty S. Goddu, Ph.D. Washington University St.
Quality Assurance of Ultrasound Imaging in Radiation Therapy Zuofeng Li, D.Sc. Murty S. Goddu, Ph.D. Washington University St. Louis, Missouri Typical Applications of Ultrasound Imaging in Radiation Therapy
More informationHDR vs. LDR Is One Better Than The Other?
HDR vs. LDR Is One Better Than The Other? Daniel Fernandez, MD, PhD 11/3/2017 New Frontiers in Urologic Oncology Learning Objectives Indications for prostate brachytherapy Identify pros/cons of HDR vs
More informationSection: Therapy Effective Date: October 15, 2016 Subsection: Therapy Original Policy Date: December 7, 2011 Subject:
Last Review Status/Date: September 2016 Page: 1 of 10 Description High-dose rate (HDR) temporary prostate brachytherapy is a technique of delivering a high-intensity radiation source directly to the prostate
More informationBrachytherapy in prostate cancer: techniques and clinical outcomes
19 Brachytherapy in prostate cancer: techniques and clinical outcomes MARK PRENTICE, WENLONG NEI, AMY LEWIS, REENA DAVDA AND HEATHER PAYNE Brachytherapy for prostate cancer involves placing radioactive
More informationAdvances in Treatment of Cancer by Brachytherapy in Kenya, in Particular, Prostate Cancer
Research Article imedpub Journals www.imedpub.com Journal Of Medical Physics And Applied Sciences ISSN 2574-285X DOI: 1.21767/2574-285X.12 Advances in Treatment of Cancer by Brachytherapy in Kenya, in
More informationHigh-Dose Rate Temporary Prostate Brachytherapy. Original Policy Date
MP 8.01.15 High-Dose Rate Temporary Prostate Brachytherapy Medical Policy Section Therapy Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Reviewed with literature search/12/2013 Return
More informationProstate Cancer: Low Dose Rate (Seed) Brachytherapy. Information for patients, families and friends
Prostate Cancer: Low Dose Rate (Seed) Brachytherapy Information for patients, families and friends About this booklet This booklet is designed to give you information about low dose-rate (seed) brachytherapy
More informationCentral European Journal of Urology
270 Central European Journal of Urology O R I G I N A L P A P E R urological oncology Low-dose-rate brachytherapy as a minimally invasive curative treatment for localised prostate cancer has excellent
More informationPatient Information. Prostate Tissue Ablation. High Intensity Focused Ultrasound for
High Intensity Focused Ultrasound for Prostate Tissue Ablation Patient Information CAUTION: Federal law restricts this device to sell by or on the order of a physician CONTENT Introduction... 3 The prostate...
More informationBrachytherapy Planning and Quality Assurance w Classical implant systems and modern computerized dosimetry w Most common clinical applications w
Brachytherapy Planning and Quality Assurance w Classical implant systems and modern computerized dosimetry w Most common clinical applications w Quality assurance Classical implant systems w Manchester
More informationBrachytherapy Planning and Quality Assurance
Brachytherapy Planning and Quality Assurance Classical implant systems Most common clinical applications and modern dosimetry methods Quality assurance Classical implant systems Manchester (Paterson-Parker)
More informationProstate Cancer. What is prostate cancer?
Scan for mobile link. Prostate Cancer Prostate cancer is a tumor of the prostate gland, which is located in front of the rectum and below the bladder. Your doctor may perform a physical exam, prostate-specific
More informationProstate Cancer. What is prostate cancer?
Scan for mobile link. Prostate Cancer Prostate cancer is a tumor of the prostate gland, which is located in front of the rectum, below the bladder and above the base of the penis. Your doctor may perform
More informationProstate Cancer Treatment
Scan for mobile link. Prostate Cancer Treatment Prostate cancer overview Prostate cancer is the most common form of cancer in American men, most prevalent in men over age 65 and fairly common in men 50-64
More informationReal-time brachytherapy for prostate cancer implant analysis
Rep Pract Oncol Radiother, 2008; 13(1): 9-14 Original Paper Received: 2007.04.17 Accepted: 2008.02.07 Published: 2008.02.29 Authors Contribution: A Study Design B Data Collection C Statistical Analysis
More informationIndex. B Biologically effective dose (BED), 158
Index B Biologically effective dose (BED), 158 C Catheter displacement, 113, 114 rectal probe, 114 self-anchoring catheters, 113 Catheter fixation, HDR, 106 107 Catheter insertion, HDR sagittal ultrasound
More informationBLADDER PROSTATE PENIS TESTICLES BE YO ND YO UR CA NC ER
BLADDER PROSTATE PENIS TESTICLES THE PROSTATE IS A SMALL, WALNUT-SIZED GLAND THAT IS PART OF THE MALE REPRODUCTIVE SYSTEM. IT RESTS BELOW THE BLADDER, IN FRONT OF THE RECTUM AND SURROUNDS PART OF THE URETHRA.
More informationMedical Policy. MP High-Dose Rate Temporary Prostate Brachytherapy
Medical Policy MP 8.01.33 BCBSA Ref. Policy: 8.01.33 Last Review: 07/25/2018 Effective Date: 07/25/2018 Section: Therapy Related Policies 7.01.79 Cryoablation of Prostate Cancer 8.01.10 Charged-Particle
More informationTechnological Advances in Radiotherapy for the Treatment of Localized Prostate Cancer - A Systematic Review
Technological Advances in Radiotherapy for the Treatment of Localized Prostate Cancer - A Systematic Review Jayatissa R.M.G.C.S.B. (B.Sc.) Department of Radiography/Radiotherapy, Faculty of Allied Health
More informationBiodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Biodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer Radiotherapy
More informationTOOKAD (padeliporfin) Patient Information Guide
TOOKAD (padeliporfin) Patient Information Guide TOOKAD is used to treat low-risk localized prostate cancer This medicine is subject to additional monitoring. This will allow quick identification of new
More informationFriday 13th May The Roxburghe Hotel, Edinburgh. Abstracts
Friday 13th May 2016 The Roxburghe Hotel, Edinburgh Abstracts NOTES ABSTRACTS FOR PRESENTATION Abstract Title First Author Institution Abstract # Page ORAL & POSTER PRESENTATION PHYSICS ABSTRACTS MRI
More informationName of Policy: High-Dose Rate Temporary Prostate Brachytherapy
Name of Policy: High-Dose Rate Temporary Prostate Brachytherapy Policy #: 024 Latest Review Date: June 2014 Category: Therapy Policy Grade: C Background/Definitions: As a general rule, benefits are payable
More informationThe clinical and cost effectiveness of the use of brachytherapy to treat localised prostate cancer Health technology description
In response to an enquiry from the Scottish Radiotherapy Advisory Group Number 37 June 2011 The clinical and cost effectiveness of the use of brachytherapy to treat localised prostate cancer Health technology
More informationFEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS
Tel: +27-21-9494060 Fax: +27-21-9494112 E-mail: leon.gouws@cancercare.co.za FEE RULES RADIATION ONCOLOGY FEE SCHEDULE CONTENTS 1. EXTERNAL BEAM RADIATION... 2 2. PLANNING OF TREATMENT... 2 3. DELIVERY
More informationProstate Seed Brachytherapy
Prostate Seed Brachytherapy Implant Patient Information Guide 2075 Bayview Avenue, T-Wing Toronto, ON Canada M4N 3M5 t: 416.480.5000 Page 1 Page 10 Radiotherapy is an effective curative treatment for many
More informationThe Leeds Teaching Hospitals NHS Trust Prostate Brachytherapy using High Dose Rate (HDR) Temporary Brachytherapy Implants
n The Leeds Teaching Hospitals NHS Trust Prostate Brachytherapy using High Dose Rate (HDR) Temporary Brachytherapy Implants Information for patients This leaflet aims to explain what happens when you have
More informationBiodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Interventional procedure consultation document Biodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer Radiotherapy
More informationHigh-dose-rate brachytherapy delivered in two fractions as monotherapy for low-risk prostate cancer
Original paper Clinical Investigations High-dose-rate brachytherapy delivered in two fractions as monotherapy for low-risk prostate cancer Ricardo Cendales, MD, MSc, Elizabeth Alwers, MD, MSc, Javier Cifuentes,
More informationLDR Monotherapy vs. HDR Monotherapy
Abstract No. 1234 LDR Monotherapy vs. HDR Monotherapy Is it time for LDR to retire? Gerard Morton 2 LDR Seed Brachytherapy First 2000 LDR patients from BCCA Low and Intermediate Risk LDR Implant Morris
More informationDescription. Section: Therapy Effective Date: October 15, 2015 Subsection: Therapy Original Policy Date: December 7, 2011 Subject:
Last Review Status/Date: September 2015 Page: 1 of 14 Description High-dose rate (HDR) temporary prostate brachytherapy is a technique of delivering a high-intensity radiation source directly to the prostate
More informationReview Article Brachytherapy for Prostate Cancer: A Systematic Review
Advances in Urology Volume 2009, Article ID 327945, 11 pages doi:10.1155/2009/327945 Review Article Brachytherapy for Prostate Cancer: A Systematic Review Georgios Koukourakis, 1 Nikolaos Kelekis, 2 Vassilios
More informationor low dose rate (LDR), brachytherapy
High dose rate brachytherapy for prostate cancer: Current techniques and applications to varying disease presentations Daniel J. Krauss, MD High dose rate (HDR) brachytherapy has been an option for managing
More informationBRACHYTHERAPY FOR PROSTATE CANCER. Dr Brandon Nguyen MBBS(Hons), FRANZCR Radiation Oncologist, The Canberra Hospital
BRACHYTHERAPY FOR PROSTATE CANCER Dr Brandon Nguyen MBBS(Hons), FRANZCR Radiation Oncologist, The Canberra Hospital PROSTATE BRACHYTHERAPY Why brachytherapy? How do we do it? What are the results? Questions?
More informationBrachytherapy. What is brachytherapy and how is it used?
Scan for mobile link. Brachytherapy Brachytherapy places radioactive sources inside the patient on a temporary or permanent basis to damage cancer cells DNA and destroy their ability to divide and grow.
More informationVarian Acuity BrachyTherapy Suite One Room Integrated Image-Guided Brachytherapy
Varian Acuity BrachyTherapy Suite One Room Integrated Image-Guided Brachytherapy The Acuity BrachyTherapy Suite Integrating Imaging, Planning, and Treatment in a Single Room Each component draws on the
More informationEvaluation of Normal Tissue Complication Probability and Risk of Second Primary Cancer in Prostate Radiotherapy
Evaluation of Normal Tissue Complication Probability and Risk of Second Primary Cancer in Prostate Radiotherapy Rungdham Takam Thesis submitted for the degree of Doctor of Philosophy in The School of Chemistry
More informationLDR Prostate Brachytherapy
LDR Prostate Brachytherapy Hitting cancer on the spot Dedicated solutions for real-time prostate seed implants www.bebig.com LDR Prostate Brachytherapy Effective Treatment of Prostate Cancer Prostate cancer
More informationSalvage HDR Brachytherapy. Amit Bahl Consultant Clinical Oncologist The Bristol Cancer Institute, UK
Salvage HDR Brachytherapy Amit Bahl Consultant Clinical Oncologist The Bristol Cancer Institute, UK Disclosures Still No financial disclosures! Limited personal experience of HDR Brachy as salvage option
More informationFriday 23 rd March The Spa Hotel, Tunbridge Wells, Kent. Abstracts. Page 1 of 9
Friday 23 rd March 2018 The Spa Hotel, Tunbridge Wells, Kent Abstracts Page 1 of 9 Abstract Title First Author Institution Abstract # Page Number The effect of bilateral treatment plan symmetry on postoperative
More informationAbstract Purpose: Material and methods: Results: Conclusions: Key words: Purpose Address for correspondence:
Original paper Physics Contributions The impact of activating source dwell positions outside the CTV on the dose to treated normal tissue volumes in TRUS guided 3D conformal interstitial HDR brachytherapy
More informationCan we deliver the dose distribution we plan in HDR-Brachytherapy of Prostate Cancer?
Can we deliver the dose distribution we plan in HDR-Brachytherapy of Prostate Cancer? Dimos Baltas Dept. of Medical Physics & Engineering, Strahlenklinik, Klinikum Offenbach GmbH 63069 Offenbach, Germany
More informationCyberKnife Monotherapy for Prostate Cancer
C H A P T E R 29 CyberKnife Monotherapy for Prostate Cancer Clinton A. Medbery Marianne M. Young Astrid E. Morrison J. Stephen Archer Maximian F. D Souza Cindy Parry Abstract The purpose of our planned
More informationAllinaHealthSystems 1
2018 Dimensions in Oncology Genitourinary Cancer Disclosures I have no financial or commercial relationships relevant to this presentation. Matthew O Shaughnessy, MD, PhD Director of Urologic Oncology
More informationHow to deal with patients who fail intracavitary treatment
How to deal with patients who fail intracavitary treatment A. Heidenreich Department of Urology Non-surgical therapy of PCA IMRT SEEDS IGRT HDR-BRACHY HIFU CRYO LDR - Brachytherapy Author Follow-up bned
More informationPROSTATE CANCER TREATMENT
PROSTATE CANCER TREATMENT INFORMATION GUIDE Several effective treatment options exist today for men diagnosed with prostate cancer. Each man s particular cancer, overall health, age, and lifestyle will
More informationBrachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds. Original Policy Date
MP 8.01.11 Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds Medical Policy Section Therapy Issue 12/2013 Original Policy Date 12/2013 Last Review Status/Date Revised
More informationSASCRO Prostate Brachytherapy Guidelines Task Group
SASCRO Prostate Brachytherapy Guidelines Task Group Anderson D 1, N Coetzee 2,Du Toit PD 3, Webb G 4 1Radiation Oncologist, Groote Schuur Hospital. 2Medical Physicist, Equra Health 3Medical Physicist,
More informationOriginal articles. Abstract. Purpose
Original article Original articles Correlation between treatment plan parameters and particular prognostic factors in prostate cancer treated with high-dose-rate brachytherapy (HDR-BT) as a boost Adam
More informationTHE UROLOGY GROUP
THE UROLOGY GROUP www.urologygroupvirginia.com 1860 Town Center Drive Suite 150/160 Reston, VA 20190 703-480-0220 19415 Deerfield Avenue Suite 112 Leesburg, VA 20176 703-724-1195 224-D Cornwall Street,
More information7/23/2014. SAM-HDR Brachytherapy II: Integration of Real Time Imaging. US-based prostate brachytherapy: are we there yet? No conflict of interest
SAM-HDR Brachytherapy II: Integration of Real Time Imaging US-based prostate brachytherapy: are we there yet? Dorin A. Todor, Ph.D. Department of Radiation Oncology, Virginia Commonwealth University, Richmond,
More informationMP Brachytherapy for Clinically Localized Prostate Cancer Using Permanently Implanted Seeds
Medical Policy MP 8.01.14 BCBSA Ref. Policy: 8.01.14 Last Review: 07/25/2018 Effective Date: 07/25/2018 Section: Therapy Related Policies 7.01.79 Cryoablation of Prostate Cancer 8.01.10 Charged-Particle
More informationProstate Cancer: High Dose Rate Brachytherapy. Information for patients, families and friends
Prostate Cancer: High Dose Rate Brachytherapy Information for patients, families and friends About this booklet This booklet is designed to give you information about high doserate (or HDR) brachytherapy
More informationReview of brachytherapy in
Medical Physics in the Baltic States 2017 Review of brachytherapy in Klaipėda University Hospital Romas Vilkas Rasa Dagienė Klaipėda University Hospital 1 Aims of presentation: To show progress of brachytherapy
More informationOver the last decade, prostate brachytherapy a radiation treatment
135 Modern Prostate Brachytherapy Prostate Specific Antigen Results in 219 Patients with up to 12 Years of Observed Follow-Up Haakon Ragde, M.D. 1 Leroy J. Korb, M.D. 1 Abdel-Aziz Elgamal, M.D. 2 Gordon
More informationProstate Cancer Case Study 1. Medical Student Case-Based Learning
Prostate Cancer Case Study 1 Medical Student Case-Based Learning The Case of Mr. Powers Prostatic Nodule The effervescent Mr. Powers is found by his primary care provider to have a prostatic nodule. You
More informationCatheter displacement prior to the delivery of high-dose-rate brachytherapy in the treatment of prostate cancer patients
Original paper Clinical Investigations Catheter displacement prior to the delivery of high-dose-rate brachytherapy in the treatment of prostate cancer patients Shogo Kawakami, MD 1, Hiromichi Ishiyama,
More informationWhat is the Role of Interstitial Brachytherapy?
What is the Role of Interstitial Brachytherapy? Stephen W. Doggett, MD In: Bowsher, W., editor. Challenges in Prostate Cancer. 1st ed. Blackwell Science, London 2000. April 7, 2000 mailing address: 14642
More informationPermanent Prostate Brachytherapy Post Procedure Evaluation
Permanent Prostate Brachytherapy Post Procedure Evaluation William S. Bice, Jr., Ph.D. UTHSCSA, San Antonio, Texas IMPS, San Antonio, Texas Texas Cancer Clinic, San Antonio, Texas Implant Evaluation for
More informationHigh dose rate brachytherapy as monotherapy for localised prostate cancer: a hypofractionated two-implant approach in 351 consecutive patients
High dose rate brachytherapy as monotherapy for localised prostate cancer: a hypofractionated two-implant approach in 351 consecutive patients Tselis et al. Tselis et al. Radiation Oncology 213, 8:115
More informationProstate cancer. Treatments Side effects and management in the community setting
Prostate cancer Treatments Side effects and management in the community setting Kristoffer Ohlin CNS Urology Janice Minter Lead Cancer Nurse St George s Hospital Agenda Prostate cancer treatments Radiotherapy
More informationWireless In-Vivo Dosimetry of High Dose Rate Brachytherapy for Prostate Cancer using MOSkin Detectors
University of Wollongong Research Online University of Wollongong Thesis Collection 2017+ University of Wollongong Thesis Collections 2018 Wireless In-Vivo Dosimetry of High Dose Rate Brachytherapy for
More informationClinical Commissioning Policy Proposition: Proton Beam Therapy for Cancer of the Prostate
Clinical Commissioning Policy Proposition: Proton Beam Therapy for Cancer of the Prostate Reference: NHS England B01X09 First published: March 2016 Prepared by NHS England Specialised Services Clinical
More informationPROSTATE CANCER CONTENT CREATED BY. Learn more at
PROSTATE CANCER CONTENT CREATED BY Learn more at www.health.harvard.edu TALK WITH YOUR DOCTOR Table of Contents Ask your doctor about screening and treatment options. WHAT IS PROSTATE CANCER? 4 WATCHFUL
More informationTransperineal Interstitial Permanent Prostate Brachytherapy (TIPPB) Quality Assurance Guidelines
Prostate Brachytherapy QA Page 1 of 1 Transperineal Interstitial Permanent Prostate Brachytherapy (TIPPB) Quality Assurance Guidelines I. Purpose Table of Contents II. III. IV. Background Credentialing
More informationModern Dose Fractionation and Treatment Techniques for Definitive Prostate RT
Modern Dose Fractionation and Treatment Techniques for Definitive Prostate RT Daniel J Bourgeois, III MD, MPH Board Certified Radiation Oncologist Southeast Louisiana Radiation Oncology Group (SLROG) Disclosures
More informationBrachytherapy for Prostate Cancer
Brachytherapy for Prostate Cancer Who should be thinking about this and why... Juanita Crook Professor Radiation Oncology University of Toronto Princess Margaret Hospital Many options watchful waiting?
More informationNew research in prostate brachytherapy
New research in prostate brachytherapy Dr Ann Henry Associate Professor in Clinical Oncology University of Leeds and Leeds Cancer Centre PIVOTAL boost opening 2017 To evaluate - The benefits of pelvic
More informationSubject Index. Androgen antiandrogen therapy, see Hormone ablation therapy, prostate cancer synthesis and metabolism 49
OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index Androgen antiandrogen therapy, see Hormone ablation therapy, synthesis and metabolism 49 Bacillus Calmette-Guérin adjunct therapy with transurethral resection
More information2/14/09. Why Discuss this topic? Managing Local Recurrences after Radiation Failure. PROSTATE CANCER Second Treatment
Why Discuss this topic? Mack Roach III, MD Professor and Chair Radiation Oncology UCSF Managing Local Recurrences after Radiation Failure 1. ~15 to 75% of CaP pts recur after definitive RT. 2. Heterogeneous
More informationThe Paul Evans Memorial Lecture Functional radiotherapy targeting using focused dose escalation. Roberto Alonzi Mount Vernon Cancer Centre
The Paul Evans Memorial Lecture Functional radiotherapy targeting using focused dose escalation Roberto Alonzi Mount Vernon Cancer Centre Overview Introduction and rationale for focused dose escalation
More informationChapter 18: Glossary
Chapter 18: Glossary Sutter Health Cancer Service Line: Prostate Committee Advanced cancer: When the cancer has spread to other parts of the body (including lymph nodes, bones, or other organs) and is
More informationKEYWORDS: prostate carcinoma, brachytherapy, magnetic resonance imaging (MRI), late toxicity. Women s Hospital and Dana Farber Cancer Institute,
949 Late Genitourinary and Gastrointestinal Toxicity after Magnetic Resonance Image-Guided Prostate Brachytherapy with or without Neoadjuvant External Beam Radiation Therapy Michele Albert, M.D. 1 Clare
More informationHDR Brachytherapy: Results and Future Studies in Monotherapy
HDR Brachytherapy: Results and Future Studies in Monotherapy Nikolaos Zamboglou and Nikolaos Tselis Strahlenklinik Klinikum Offenbach - Germany Prostate Brachytherapy UK & Ireland Conference 2013 Comparison
More informationProstate Cancer Canada Network - NEWMARKET Volume 23, Issue 7 March 9, 2018 PEER TO PEER SESSION
Prostate Cancer Canada Network - NEWMARKET Volume 23, Issue 7 March 9, 2018 A support group that provides understanding, hope and information to prostate cancer patients and their families. Topic for the
More informationProstate Cancer Treatment Decision Information Background
Prostate Cancer Treatment Decision Information Background A group of Radiotherapy Clinics of Georgia (RCOG) prostate cancer (PCa) patients developed this web site, in part, based on a slide presentation
More informationDOSE ESCALATION USING CONFORMAL HIGH-DOSE-RATE BRACHYTHERAPY IMPROVES OUTCOME IN UNFAVORABLE PROSTATE CANCER
PII S0360-3016(02)02733-5 Int. J. Radiation Oncology Biol. Phys., Vol. 53, No. 2, pp. 316 327, 2002 Copyright 2002 Elsevier Science Inc. Printed in the USA. All rights reserved 0360-3016/02/$ see front
More informationAdvanced dose calculations and imaging in prostate brachytherapy treatment planning. Joshua William Mason
Advanced dose calculations and imaging in prostate brachytherapy treatment planning. Joshua William Mason Submitted in accordance with the requirements for the degree of Doctor of Philosophy The University
More informationCan we deliver the dose distribution we plan in HDR-Brachytherapy of Prostate Cancer?
Can we deliver the dose distribution we plan in HDR-Brachytherapy of Prostate Cancer? Dimos Baltas 1,3, Natasa Milickovic 1, Nikolaos Zamboglou 2 1 Dept. of Medical Physics & Engineering, 2 Strahlenklinik,
More informationpat hways Medtech innovation briefing Published: 16 December 2014 nice.org.uk/guidance/mib16
pat hways The Oncentra Prostate v4.x for ultrasound-guided real-time HDR brachytherapy in men with localised prostate cancer Medtech innovation briefing Published: 16 December 2014 nice.org.uk/guidance/mib16
More informationHow ICD-10 Affects Radiation Oncology. Presented by, Lashelle Bolton CPC, COC, CPC-I, CPMA
How ICD-10 Affects Radiation Oncology Presented by, Lashelle Bolton CPC, COC, CPC-I, CPMA ICD-10 ICD-10-CM has added new challenges to the radiation oncology specialty. Approximately 220 ICD-9-CM codes
More informationQuality of life after high-dose-rate brachytherapy monotherapy for prostate cancer
ORIGINAL ARTICLE Vol. 41 (1): 40-45, January - February, 2015 doi: 10.1590/S1677-5538.IBJU.2015.01.07 Quality of life after high-dose-rate brachytherapy monotherapy for prostate cancer Jessika A. Contreras
More informationCurrent and Emerging Standards in Radiation Therapy for Prostate Cancer
Current and Emerging Standards in Radiation Therapy for Prostate Cancer Amandeep R. Mahal, BS, and James B. Yu, MD, MHS Abstract Improved radiation technology has allowed physicians to precisely target
More informationRadiation Therapy. External Beam Radiation Therapy
Radiation Therapy Radiation therapy is a non-invasive treatment for prostate cancer that uses x-rays or gamma-rays to eradicate prostate cancer cells. There are several forms of radiation therapy that
More informationUltrasoundeCT fusion compared with MReCT fusion for postimplant dosimetry in permanent prostate brachytherapy
Brachytherapy 12 (2013) 38e43 UltrasoundeCT fusion compared with MReCT fusion for postimplant dosimetry in permanent prostate brachytherapy David Bowes 1, Juanita M. Crook 2, *, Cynthia Araujo 3, Deidre
More informationHow can we best use HDR brachytherapy to escalate dose in intermediate and high risk disease? Gerard Morton Associate Professor
How can we best use HDR brachytherapy to escalate dose in intermediate and high risk disease? Gerard Morton Associate Professor Objectives Why should we escalate dose? What HDR dose and fractionation should
More informationRadiotherapy and Oncology
Radiotherapy and Oncology 107 (2013) 325 332 Contents lists available at SciVerse ScienceDirect Radiotherapy and Oncology journal homepage: www.thegreenjournal.com GEC/ESTRO recommendations GEC/ESTRO recommendations
More informationDefinitions. Brachytherapy in treatment of cancer. Implantation Techniques and Methods of Dose Specifications. Importance of Brachytherapy in GYN
Implantation Techniques and Methods of Dose Specifications Brachytherapy Course Lecture V Krishna Reddy, MD, PhD Assistant Professor, Radiation Oncology Brachytherapy in treatment of cancer GYN Cervical
More information