Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?

Valentine Guimas 1 Magali Quivrin 2, 1 Aurélie Bertaut 3 Etienne Martin 1 Damien Chambade 1 Philippe Maingon 1 Frédéric Mazoyer 1 Luc Cormier 4 Gilles Créhange 2, 1, *
* Auteur correspondant
1 Département de Radiation oncologie, CGFL
2 Le2i - Laboratoire Electronique, Informatique et Image [UMR6303]
3 Unité de biostatistiques [Centre Georges-François Leclerc]
4 Département d'Urologie, CHU François Mitterrand
Abstract : PURPOSE: Salvage prostate permanent implant (sPPI) for postradiation local failure provides high rates of biochemical control. The cumulative dose delivered to the prostate and the rectum is still unknown. METHODS AND MATERIALS: We reviewed the postimplant CT-based dosimetry of 18 selected patients who underwent sPPI with I-125 seeds for isolated biopsy-proven local failure several years after external beam radiation therapy. Ten patients had whole-prostate sPPI, and 8 patients had multiparametric MRI-based focal sPPI. In 8 patients, hyaluronic acid (HA) gel was injected into the prostate rectum space. RESULTS: The median cumulative biological effective dose after EBRT sPPI for the prostate and the rectum was higher in patients treated with whole-gland sPPI than in patients treated with focal sPPI (313.5 Gy(2) vs. 174.4 Gy(2); p = 0.06 and 258.1 Gy(3) vs. 172.6 (Gy3); p < 0.01, respectively). The median Dolcc for the rectum was significantly lower in patients who had HA gel: 63.3 Gy (29.0-78.3) vs. 83.9 Gy (34.9-180.0) (p = 0.04). CONCLUSIONS: Cumulative prostate and rectum biological effective doses were lower with focal sPPI. Duce delivered to the rectum was significantly lower with HA gel, while there was no difference between focal or whole-gland plans. (C) 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
Keywords : Prostate cancer Local failure Salvage brachytherapy Low dose rate Biologically effective dose Radiation-Therapy Permanent Brachytherapy Cancer Recurrences Radiotherapy Implantation Carcinoma Recommendations Alpha/Beta Men
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Contributeur : Le2i - Université de Bourgogne <>
Soumis le : jeudi 12 janvier 2017 - 19:28:11
Dernière modification le : mercredi 12 septembre 2018 - 01:26:10

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Valentine Guimas, Magali Quivrin, Aurélie Bertaut, Etienne Martin, Damien Chambade, et al.. Focal or whole-gland salvage prostate brachytherapy with iodine seeds with or without a rectal spacer for postradiotherapy local failure: How best to spare the rectum?. Brachytherapy, Elsevier, 2016, 15 (4), pp.406 - 411. ⟨10.1016/j.brachy.2016.03.014⟩. ⟨hal-01433672⟩

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