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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Novel prostate brachytherapy technique: Improved dosimetric and clinical outcome.
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Novel prostate brachytherapy technique: Improved dosimetric and clinical outcome.

机译：新型前列腺近距离放射治疗技术：改善剂量和临床效果。

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PURPOSE: Erectile dysfunction following prostate brachytherapy is reported to be related to dose received by the penile bulb. To minimise this, whilst preserving prostate dosimetry, we have developed a technique for I-125 seed brachytherapy using both stranded seeds and loose seeds delivered with a Mick applicator, and implanted via the sagittal plane on trans-rectal ultrasound. MATERIALS AND METHODS: Post-implant dosimetry and potency rates were compared in 120 potent patients. In Group 1, 60 patients were treated using a conventional technique of seeds implanted in a modified-uniform distribution. From January 2005, a novel technique was developed using stranded seeds peripherally and centrally distributed loose seeds implanted via a Mick applicator (Group 2). The latter technique allows greater flexibility when implanting the seeds at the apex. Each patient was prescribed a minimum peripheral dose of 145Gy. No patients received external beam radiotherapy or hormone treatment. There was no significant difference in age or pre-implant potency score (mean IIEF-5 score 22.4 vs. 22.6, p=0.074) between the two groups. RESULTS: The new technique delivers lower penile bulb doses (D(25) as %mPD - Group 1: 61.2+/-35.7, Group 2: 29.7+/-16.0, p0.0001; D(50) as %mPD - Group 1: 45.8+/-26.9, Group 2: 21.4+/-11.7, p0.0001) whilst improving prostate dosimetry (D(90) - Group 1: 147Gy+/-21.1, Group 2: 155Gy+/-16.7, p=0.03). At 2 years, the potency rate was also improved: Group 1: 61.7%; Group 2: 83.3% (p=0.008). CONCLUSIONS: In this study, the novel brachytherapy technique using both peripheral stranded seeds and central loose seeds delivered via a Mick applicator results in a lower penile bulb dose whilst improving prostate dosimetry, and may achieve higher potency rates.
机译：目的：前列腺近距离放射治疗后的勃起功能障碍据报道与阴茎鳞茎接受的剂量有关。为了最大程度地减少这种情况，我们在保留前列腺剂量的同时，还开发了一种I-125种子近距离放射治疗技术，该技术使用绞合种子和散装种子（由Mick施加器提供），并通过矢状面植入经直肠超声中。材料与方法：比较了120位强效患者的植入后剂量测定和效价率。在第1组中，使用常规技术以改良的均匀分布植入了60名患者。从2005年1月开始，开发了一种新技术，该技术使用通过Mick施药器（第2组）植入的种子在外围和中央分布的散落种子。当将种子植入顶点时，后一种技术具有更大的灵活性。每位患者的最小外周剂量为145Gy。没有患者接受外部束放射疗法或激素治疗。两组之间的年龄或植入前效能评分（IIEF-5平均评分22.4 vs. 22.6，p = 0.074）均无显着差异。结果：新技术可提供较低的阴茎鳞茎剂量（D（25）为％mPD-组1：61.2 +/- 35.7，组2：29.7 +/- 16.0，p <0.0001; D（50）为％mPD-组1：45.8 +/- 26.9，组2：21.4 +/- 11.7，p <0.0001）同时改善了前列腺剂量（D（90）-组1：147Gy +/- 21.1，组2：155Gy +/- 16.7，p = 0.03 ）。在2年时，效价率也有所提高：第1组：61.7％;第2组：83.3％（p = 0.008）。结论：在这项研究中，新的近距离放射治疗技术同时使用通过Mick施药器递送的周围绞合种子和中央疏松种子，产生了较低的阴茎鳞茎剂量，同时提高了前列腺剂量，并可能达到更高的效力。

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