Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy
Purpose: To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated with low-dose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting of a histologic dominant intra-epithelial lesion (DIL) to those without a DIL. Methods: 455 patients with IR-PCa were t...
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doaj-86aa365e839541929465830c50d913d72020-11-25T03:07:24ZengElsevierHeliyon2405-84402020-06-0166e04092Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapyKevin Martell0Soumyajit Roy1Tyler Meyer2Jordan Stosky3Will Jiang4Kundan Thind5Michael Roumeliotis6John Bosch7Steve Angyalfi8Harvey Quon9Siraj Husain10University of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, Canada; Corresponding author.University of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, Canada; Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USAUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaAlberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaUniversity of Calgary, Department of Oncology, Calgary, AB, Canada; Alberta Health Services, Calgary Zone, Calgary, AB, CanadaPurpose: To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated with low-dose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting of a histologic dominant intra-epithelial lesion (DIL) to those without a DIL. Methods: 455 patients with IR-PCa were treated at a single center with intra-operatively planned LDR-BT, each following the same in-house dose constraints. Patients with a DIL on pathology had hot spots localized to that region but no specific contouring during the procedure. Results: 396 (87%) patients had a DIL. Baseline tumor characteristics and overall prostate dosimetry were similar between patients with and without DIL except the median number of biopsy cores taken: 10 (10–12) vs 12 (10–12) (p = 0.002).19 (5%) and 18 (5%) of patients with and 1 (2%) and 0 (0%) of those without DIL experienced CTCAE grade 2 and 3 toxicity respectively. Overall, toxicity grade did not significantly correlate with presence of DIL (p = 0.10).Estimated 7-year freedom from biochemical failure (FFBF) was 84% (95% confidence interval: 79–89) and 70% (54–89) in patients with and without a DIL (log-rank p = 0.315). In DIL patients, cox regression revealed location of DIL (“Base” vs “Apex” HR: 1.03; 1.00–1.06; p = 0.03) and older age (70 vs 60 HR: 1.62; 1.06–2.49; p = 0.03) was associated with poor FFBF. Conclusions: Targeting DIL through dose painting during intraoperatively planned LDR-BT provided no statistically significant change in FFBF. Patients with DILs in the prostate base had slightly lower FFBF despite DIL boost.http://www.sciencedirect.com/science/article/pii/S2405844020309361Radiation physicsSurgeryCancer surgeryUrologyOncologyProstate cancer |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kevin Martell Soumyajit Roy Tyler Meyer Jordan Stosky Will Jiang Kundan Thind Michael Roumeliotis John Bosch Steve Angyalfi Harvey Quon Siraj Husain |
spellingShingle |
Kevin Martell Soumyajit Roy Tyler Meyer Jordan Stosky Will Jiang Kundan Thind Michael Roumeliotis John Bosch Steve Angyalfi Harvey Quon Siraj Husain Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy Heliyon Radiation physics Surgery Cancer surgery Urology Oncology Prostate cancer |
author_facet |
Kevin Martell Soumyajit Roy Tyler Meyer Jordan Stosky Will Jiang Kundan Thind Michael Roumeliotis John Bosch Steve Angyalfi Harvey Quon Siraj Husain |
author_sort |
Kevin Martell |
title |
Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
title_short |
Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
title_full |
Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
title_fullStr |
Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
title_full_unstemmed |
Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
title_sort |
analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy |
publisher |
Elsevier |
series |
Heliyon |
issn |
2405-8440 |
publishDate |
2020-06-01 |
description |
Purpose: To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated with low-dose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting of a histologic dominant intra-epithelial lesion (DIL) to those without a DIL. Methods: 455 patients with IR-PCa were treated at a single center with intra-operatively planned LDR-BT, each following the same in-house dose constraints. Patients with a DIL on pathology had hot spots localized to that region but no specific contouring during the procedure. Results: 396 (87%) patients had a DIL. Baseline tumor characteristics and overall prostate dosimetry were similar between patients with and without DIL except the median number of biopsy cores taken: 10 (10–12) vs 12 (10–12) (p = 0.002).19 (5%) and 18 (5%) of patients with and 1 (2%) and 0 (0%) of those without DIL experienced CTCAE grade 2 and 3 toxicity respectively. Overall, toxicity grade did not significantly correlate with presence of DIL (p = 0.10).Estimated 7-year freedom from biochemical failure (FFBF) was 84% (95% confidence interval: 79–89) and 70% (54–89) in patients with and without a DIL (log-rank p = 0.315). In DIL patients, cox regression revealed location of DIL (“Base” vs “Apex” HR: 1.03; 1.00–1.06; p = 0.03) and older age (70 vs 60 HR: 1.62; 1.06–2.49; p = 0.03) was associated with poor FFBF. Conclusions: Targeting DIL through dose painting during intraoperatively planned LDR-BT provided no statistically significant change in FFBF. Patients with DILs in the prostate base had slightly lower FFBF despite DIL boost. |
topic |
Radiation physics Surgery Cancer surgery Urology Oncology Prostate cancer |
url |
http://www.sciencedirect.com/science/article/pii/S2405844020309361 |
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