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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 3D-simulation model made with a milling system was applied to HDR-brachytherapy. The 3D-simulation model is used to simulate the 3D-structure of the lesion and the surrounding organs before the actual catheterization for brachytherapy. The first case was recurrent prostatic cancer in a 61-year-old man. The other case was lymph node recurrence of a 71-year-old woman's upper gum cancer. In both cases, the 3D-simulation model was very useful to simulate the 3D-conformation, to plan the treatment process and to avoid the risk accompanying treatment.
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PMID:[Planning for brachytherapy using a 3D-simulation model]. 763 59

Between 1986 and 1995 a hundred and seventy-four patients with prostate cancer staged for T1b-T3c N0 M0 were treated with a combined tele- and HDR brachytherapy regimen. The distribution of stage and grading was as follows: T1b two patients, T2a-2c 113 patients T3a-3c 59 patients, and G1 27 patients, G2 87 patients, G3 60 patients respectively. The total dose administered for the subclinical disease (small pervis) was 50 Gy by teletherapy and 30 Gy via two fractions of 15 Gy HDR brachytherapy integrated in the percutaneous regime. Total treatment time 6 weeks. After a median follow-up of 50 months (8-103) the stage related systemic and local progression amounts for stage T3 15.25% and for stage T1-2 20.43%, respectively. The distribution of systemic and local progression related to histological grading is: for Grade G3 23.3% and for Grade G1-2 6.14%. Ten patients died tumor related and 18 others of intercurrent diseases. The overall survival amounts 84%, the cancer specific survival 94% and the disease free survival 88% respectively. The late radiation morbidity scored by the RTOG/EORTC score in relation to proctitis was: 12 Patients Grade I, 10 patients Grade II, and 5 cases (one of five with abdominal anus) Grade III, respectively. In terms of radiogenic cystitis 13 patients developed Grade I side effects, 5 Grade II, and 3 Grade III, respectively. One osteoporotic patient developed a radionecrosis of both bones.
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PMID:[Interstitial high dosage irradiation of prostate carcinoma]. 970 11

Because the HDR brachytherapy treatments are delivered within minutes and on an outpatient basis, HDR brachytherapy is very well tolerated by patients and offers complete radiation safety. Published studies2, 11, 12, 13, 16, 17, 18, 22, 24, 25 have shown high local clinical and biochemical control rates. Chronic complications have been acceptably low. Very low rates of urinary incontinence and high sexual potency rates have been reported. Gastrointestinal morbidity has been minimal. The development of Ir-192 HDR afterloading brachytherapy and refinements in the dosimetry have ushered in a new era in prostate brachytherapy. The control of the radiation dose and the ability to shape the radiation treatment envelope using a stepping source have allowed a giant step forward in radiation oncology technology. It is now possible to deliver tumoricidal doses of radiation conformally to the prostate while minimizing the dose to the bladder, urethra, and rectum. At present, HDR afterloaded brachytherapy is the optimal whole-organ and tumor-specific conformal radiation therapy for prostate cancer.
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PMID:High dose rate brachytherapy in the treatment of prostate cancer. 1043 25

Brachytherapy can deliver high doses of radiation to a tumor with only low doses to the normal tissue. Brachytherapy can be classified as intracavitary, intraluminar and interstitial radiotherapy. It can be also divided into three groups according to dose rate: low (LDR), medium (MDR) and high (HDR) dose rates. In recent years, HDR remotely controlled afterloading systems are widespread in Japan. HDR brachytherapy has solved the problem of radiation exposure for medical staff, and patients need not be isolated in highly sealed rooms. Local control rates of T1 and T2 tongue cancer treated with LDR interstitial radiation using 226Ra and 192Ir were 80% and 67%. A phase III trial of HDR versus LDR interstitial brachytherapy for early tongue cancer revealed the same local control rates between the two groups. For uterine cervix cancer, the cause-specific survival rates of patients treated with HDR intracavitary brachytherapy were almost the same as those treated with LDR. HDR brachytherapy can be applied against recurrent tumors. Almost half of recurrent tumors can be controlled with HDR treatment. Brachytherapy is widely used for prostate cancer in the USA. LDR brachytherapy using 125I seeds is used for prostate cancer. In Japan, 125I seeds can not be used because of the regulation of radioisotopes, so we treat prostate cancer patients with HDR brachytherapy. The two-year biochemical NED rate is 83%. Brachytherapy has a long history of nearly 100 years. In recent years, the development of an HDR remotely controlled afterloading system and treatment planning system allows us to make a precise treatment plan and a uniform dose distribution. In the next century, HDR-brachytherapy will continue to play an important role in the field of radiotherapy.
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PMID:[Present and future in brachytherapy--from the discovery of radium to the 21st century]. 1047 77

We have developed a new interstitial HDR brachytherapy technique for the treatment of prostate cancer using CT based 3D planning after transrectal implantation of four non-parallel needles. CT based needle reconstruction, target definition, evaluation and documentation, including DVHs and 3D imaging, is a feasible, safe and well tolerated treatment concept.
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PMID:New interstitial HDR brachytherapy technique for prostate cancer: CT based 3D planning after transrectal implantation. 1058 Aug 73

Although reduction in the serum prostate specific antigen (PSA) correlates with clinical outcome for high dose rate Iridium-192 (HDR Ir-192) brachytherapy, it takes a long latency period. We investigated numerical chromosome changes of prostatic cancer during the pre- and post-treatment periods of HDR Ir-192 brachytherapy (and external beam radiotherapy), using fluorescence in situ hybridization (FISH) to clear the effect of treatment in early phase. Transitional changes in the frequency of aneuploidy for chromosomes 7, 8, 10, 12, 16, X, and Y in prostate cancer during the pre- and post-treatment periods were observed. Gains of chromosomes 7, 8 and 12 were noted in the pre-treatment samples (4 out of 12 cases in chromosomes 7 and 8; 1 out of 12 cases in chromosome 12), while a notable reduction in the number of cells with extra copies of these chromosomes was observed in post-treatment specimens. This change appears earlier than the reduction in the value of prostate specific antigen (PSA) and strongly reflects the effect of HDR brachytherapy with external beam radiotherapy in localized prostate cancer. Decrease in the number of cells with high ploidies of chromosomes 7, 8 and 12 at 12 weeks after treatment may predict clinical effects of radiation therapy, which may explain the radiation dependency of localized prostate cancer cells.
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PMID:Early reduction in the aneuploidy at chromosomes 7 and 8 are significantly correlated with clinical effect in high-dose rate brachytherapy with external beam radiotherapy in localized prostate cancer. 1171 84

Our purpose in this study was to determine the influence of radiotherapy, especially brachytherapy, on the activity of natural killer cells (NK). We examined changes in NK activity before and after radiotherapy in 27 patients who underwent radiotherapy with or without brachytherapy, comprising of 16 cases of cervical cancer (three recurrences), 5 of prostate cancer, 4 of esophageal cancer and 2 of tongue cancer. Fourteen intracavitary procedures (for 13 cervical cancers and 1 esophageal cancer) and 10 interstitial brachytherapy (for 3 cases of recurrent cervical cancer, 5 of prostate cancer and 2 of tongue cancer) were performed with Ir-192 microSelectron HDR and Selectron Cs-137. External radiotherapy consisted of 10 MV X-ray administration for 13 cases of cervical cancer and 4 of esophageal cancer. The number of white blood cell was reduced by radiotherapy from 5065 +/- 2002 count/ml to 4281 +/- 1392 count/ml (p=0.02), that of lymphocytes from 1518 +/- 817 to 762 +/- 409 /ml (p<0.0001), and that of CD 16+ cells from 274 +/- 197 to 14 +/- 96 (p=0.03). No significant change was observed in the number of CD 56+ cells (274 +/- 166 to 211 +/- 153 /ml). Overall NK activity was reduced by radiotherapy from 37 +/- 19% to 30 +/- 19% (p=0.001). External radiotherapy with or without brachytherapy reduced NK activity from 33 +/- 18% to 23 +/- 16% (p=0.004). However interstitial brachytherapy produced little change in NK activity from 42 +/- 18 to 39 +/- 19%). Radiotherapy reduced the number of white blood cell, lymphocyte and CD 16+ cells. Although external radiotherapy suppressed NK activity, only brachytherapy showed little influence on NK activity alteration.
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PMID:Changes in natural killer cell activity by external radiotherapy and/or brachytherapy. 1183 8

Although the optimal management of patients with locally advanced prostate cancer remains undefined, sufficient clinical data have emerged showing that patients treated with radiation therapy (RT) have a significantly better outcome as the dose to the gland is escalated. What remains unresolved, however, is how to best deliver these higher tumoricidal doses of RT. Conformal high-dose rate brachytherapy (C-HDR BT) is an alternative means of precise dose escalation that offers similar tumoricidal effects as 3-dimensional (3D) conformal external beam radiotherapy (EBRT) with potential additional advantages. By placing HDR afterloading needles directly into the prostate gland under real-time ultrasound guidance, a steep dose gradient between the prostate and adjacent normal tissues can be generated that is unaffected by organ motion and edema or treatment setup uncertainties. The ability to control the amount of time the single radioactive source dwells at each position along the length of each brachytherapy catheter further enhances the conformity of the dose. In addition, recent radiobiologic data on prostate cancer treatment suggest that the alpha/beta ratio for tumor control is similar to (or possibly even smaller) than that for surrounding late-responding normal tissues. If true, hypofractionation (as practiced with C-HDR BT combined with EBRT) would be expected to produce tumor control and late sequelae that are at least as good as achieved with conventional fractionation, with the additional possibility that early sequelae might be reduced. Recent data from several groups performing C-HDR BT in patients with locally advanced disease have confirmed these assumptions. Combined with the physical advantages discussed earlier, C-HDR BT as a means of dose escalation should provide similar tumor control as 3D conformal EBRT with the added advantages of reduced treatment times, less acute toxicity, and no additional technological requirements to account and correct for treatment setup uncertainties and organ motion. The issues that remain unresolved with this technique (as with other methods of dose escalation) revolve around the amount of additional dose required to provide optimal tumor control, the role of androgen deprivation in the management of patients with locally advanced disease, and whether the regional lymphatics should be irradiated.
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PMID:The role of high-dose rate brachytherapy in locally advanced prostate cancer. 1272 39

The optimal treatment of patients with localized prostate cancer remains controversial. Significant clinical data are available, however, demonstrating that patients treated with radiation therapy (RT) have a significantly better outcome as the dose to the gland is increased. What remains debatable, however, is how to best deliver these higher doses of RT without significantly increasing normal tissue toxicities. Conformal high dose rate brachytherapy (C-HDR BT) represents an alternative means of precise dose delivery that offers similar tumoricidal effects as three-dimensional (3D) conformal external beam radiotherapy (EBRT) or permanent interstitial prostate seed implants with potential additional advantages. Since C-HDR BT consists of temporarily placing afterloading needles or catheters directly into the prostate gland under real-time ultrasound guidance, a steep dose gradient between the prostate and adjacent normal tissues can be generated that is minimally affected by organ motion and edema or treatment setup uncertainties. The ability to control the amount of time the single HDR radioactive source "dwells" at each position along the length of each brachytherapy catheter further enhances the conformity of the dose. In addition, recent radiobiological data on prostate cancer treatment suggest that C-HDR BT should produce tumor control and late normal tissue side effects that are at least as good as achieved with conventional fractionation, with the additional possibility that acute side effects might be reduced. Published data from several groups performing C-HDR BT as boosts in patients with locally advanced disease have supported these assumptions. Combined with the physical advantages discussed above, C-HDR BT should provide similar tumor control as 3D conformal EBRT with the added advantages of reduced treatment times, less acute toxicity, and no additional technological requirements to account and correct for treatment setup uncertainties and organ motion. Due to the success of C-HDR BT as boost treatment in locally advanced disease, this form of radiation treatment has recently been applied to low-risk prostate cancer patients as an alternative brachytherapy technique to permanent interstitial seed implantation. Advantages in this setting include an improved ability to define and deliver the prescribed dose, a significantly shortened treatment schedule compared to 3D conformal EBRT, and the fact that patients are not radioactive after implantation.
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PMID:High dose rate brachytherapy in the treatment of prostate cancer. 1290 8

Fractionated high dose rate afterloading brachytherapy for prostate cancer requires a robust means of catheter fixation with good quality assurance. Catheter position and dosimetry has been formally evaluated in 20 consecutive patients representing a total of 332 catheters undergoing two HDR afterloading brachytherapy fractions over 36 h. The mean interfraction movement of catheters as measured by external length was less than 1 mm, but within the prostate on consecutive CT scans there was a mean interfraction movement of 11.5 mm away from the prostate base. This has a significant impact on implant dosimetry as measured by D90 and the COIN index, unless corrected by repositioning the catheters.
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PMID:High dose rate afterloading brachytherapy for prostate cancer: catheter and gland movement between fractions. 1312 36


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