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Task force develops new radiation guidelines for brachytherapy
November 03, 2009Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient, according to a new guideline co-authored by Yan Yu, Ph.D., director of Medical Physics in the department of Radiation Oncology at Thomas Jefferson University.
The guideline was issued by a task group commissioned by the American Association of Physicists in Medicine (AAPM), and will be published in the November 2009 issue of Medical Physics.
With the widespread use of image-guided dosimetry, there is a need for developing a consensus methodology for dose prescription and reporting for prostate brachytherapy. The dosimetric parameters used for evaluating an implant are dependent on physician's delineation of the prostate, rectum, bladder and urethra on post-implant imaging such as CT. Many research groups have reported that such delineation can be quite variable.
With the intent of providing consistent and reproducible dosimetric information without increasing healthcare costs, the AAPM Task Group 137 issued new recommendations and guidelines on the timing, imaging techniques, dose planning criteria and dose evaluation parameters that should be followed in documenting each brachytherapy treatment.
"This is a timely update of the original AAPM Task Group 64 report, which was instrumental in defining the early standards of practice when brachytherapy became widespread in the treatment of prostate cancer," said Dr. Yu, who also chaired the original Task Group 64 in 1998-1999. "Sophisticated brachytherapy techniques such as real-time planning, image-guided robotic implantation and dynamic dose verification are either here or imminent. The field requires a higher level of standardization, which is exactly what Task Group 137 was commissioned to address."
Based on recent brachytherapy literature, the new AAPM Task Group report recommended guidelines for dose prescription from a physics perspective for routine patient treatment, clinical trials, and for treatment planning software developers. It continues to follow the current recommendations on using D90 and V100 as the primary quantities, with more specific guidelines on the use of the imaging modalities for post-implant evaluation and the optimum timing of the imaging for specific radionuclides. In addition, the new report encourages the use of a radiobiological model with a specific set of parameters to facilitate relative comparisons of treatment plans reported by different institutions using different loading patterns or radionuclides.
Thomas Jefferson University
With the intent of providing consistent and reproducible dosimetric information without increasing healthcare costs, the AAPM Task Group 137 issued new recommendations and guidelines on the timing, imaging techniques, dose planning criteria and dose evaluation parameters that should be followed in documenting each brachytherapy treatment.
"This is a timely update of the original AAPM Task Group 64 report, which was instrumental in defining the early standards of practice when brachytherapy became widespread in the treatment of prostate cancer," said Dr. Yu, who also chaired the original Task Group 64 in 1998-1999. "Sophisticated brachytherapy techniques such as real-time planning, image-guided robotic implantation and dynamic dose verification are either here or imminent. The field requires a higher level of standardization, which is exactly what Task Group 137 was commissioned to address."
Based on recent brachytherapy literature, the new AAPM Task Group report recommended guidelines for dose prescription from a physics perspective for routine patient treatment, clinical trials, and for treatment planning software developers. It continues to follow the current recommendations on using D90 and V100 as the primary quantities, with more specific guidelines on the use of the imaging modalities for post-implant evaluation and the optimum timing of the imaging for specific radionuclides. In addition, the new report encourages the use of a radiobiological model with a specific set of parameters to facilitate relative comparisons of treatment plans reported by different institutions using different loading patterns or radionuclides.
Thomas Jefferson University
Brachytherapy Current Events and Brachytherapy News RSSHormone therapy for prostate cancer patients with heart conditions linked to increased death risk
Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death.
Study shows seed implants a suitable prostate cancer treatment option for men of all ages
Men diagnosed with prostate cancer have a number of treatments to choose from, but it's a daunting task to figure out the right mix of therapies for an individual patient.
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External beam partial breast irradiation most cost-effective treatment
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Long-term study shows low oxygen levels in prostate tumors can predict recurrence
Fox Chase Cancer Center researchers have discovered that low-oxygen regions in prostate tumors can be used to predict a rise in prostate-specific antigen (PSA) levels, a marker of tumor recurrence in prostate cancer.
Radiation device in the breast reduces complications for early stage breast cancer patients
A new study shows that the SAVI™ applicator, a small, expandable device inserted inside the breast to deliver partial breast irradiation, carries a low infection risk, a potential complication of such devices.
Agent Orange exposure increases veterans' risk of aggressive recurrence of prostate cancer
Veterans exposed to Agent Orange are at increased risk of aggressive recurrence of prostate cancer, researchers report.
High dosage brachytherapy obtains excellent results in head and neck tumors
High-dosage perioperative brachytherapy (applied within the surgical process) obtains excellent results in the treatment of head and neck tumours, at the same time as reducing the period of radiation.
Early results favorable for 5-day radiation treatment of early stage prostate cancer
Preliminary results show that a shortened course of radiation therapy for prostate cancer called stereotactic body radiation therapy (SBRT) provides good PSA response for early-stage prostate cancer and has the same side effects as other treatments.
Family history of prostate cancer does not affect some treatment outcomes
In a first of its kind study, a first-degree family history of prostate cancer has no impact on the treatment outcomes of prostate cancer patients treated with brachytherapy (also called seed implants), and patients with this type of family history have clinical and pathologic characteristics similar to men with no family history at all, according to a January 1 study in the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology.
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