Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation.

Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation. Research Abstract Details 

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Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation. Abstract Text:

PURPOSE: To demonstrate how postimplantation analysis is useful for improving permanent seed implantation and reducing toxicity. PATIENTS AND METHODS: We evaluated 197 questionnaires completed by patients after permanent seed implantation (monotherapy between 1999 and 2003). For 70% of these patients, a computed tomography was available to perform postimplantation analysis. The index doses and volumes of the dose-volume histograms (DVHs) were determined and categorized with respect to the date of implantation. Differences in symptom scores relative to pretherapeutic status were analyzed with regard to follow-up times and DVH descriptors. Acute and subacute toxicities in a control group of 117 patients from an earlier study (June 1999 to September 2001) by Wust et al. (2004) were compared with a matched subgroup from this study equaling 110 patients treated between October 2001 and August 2003. RESULTS: Improved performance, identifying a characteristic time dependency of DVH parameters (after implantation) and toxicity scores, was demonstrated. Although coverage (volume covered by 100% of the prescription dose of the prostate) increased slightly, high-dose regions decreased with the growing experience of the users. Improvement in the DVH and a reduction of toxicities were found in the patient group implanted in the later period. A decline in symptoms with follow-up time counteracts this gain of experience and must be considered. Urinary and sexual discomfort was enhanced by dose heterogeneities (e.g., dose covering 10% of the prostate volume, volume covered by 200% of prescription dose). In contrast, rectal toxicities correlated with exposed rectal volumes, especially the rectal volume covered by 100% of the prescription dose. CONCLUSION: The typical side effects occurring after permanent seed implantation can be reduced by improving the dose distributions. An improvement in dose distributions and a reduction of toxicities were identified with elapsed time between 1999 and 2003.

Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation. Publishing Authors By Initials

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Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: International journal of radiation oncology, biolo

VOLUME: 71

Page Numbers: 28-35

Journal Abbreviation: Int. J. Radiat. Oncol. Biol. P

ISSN: 0360-3016

DAY: 26

MONTH: 11

YEAR: 2007

Postimplantation analysis enables improvement of dose-volume histograms and reduction of toxicity for permanent seed implantation. Information

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LANGUAGE: eng

NlmUniqueID: 7603616

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AFFILIATION: Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany.

Country: United States

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MEDLINETA: Int J Radiat Oncol Biol Phys

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