Brachytherapy
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Multicenter Study
Updated feasibility and reproducibility results of multi-institutional study of noninvasive breast tumor bed boost.
To report updated feasibility and reproducibility results for high-dose-rate noninvasive breast brachytherapy (NIBB) for tumor bed boost with whole breast radiation therapy (WBRT) in the setting of expanded patient and treatment facility number. ⋯ NIBB represents an alternative method for delivery of breast tumor cavity boost that has shown feasibility in a diverse group of both academic and community-based practices with reproducible early cosmesis and tumor control results. Recommendations are updated noting ideal timing of boost delivery likely to be before or early during WBRT given equal cosmesis and less documented treatment discomfort.
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We aimed to evaluate the impact of timing of androgen deprivation therapy (ADT) on survival in a cohort of patients with biochemical recurrence (BCR) after brachytherapy treatment for prostate cancer. ⋯ Among a cohort of brachytherapy patients, we identified no significant difference in survival for delayed salvage hormonal therapy. Shorter PSA doubling time and time to BCR are significantly associated with adverse outcomes, and these patients should be considered for immediate salvage therapy.
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There is strong evidence relating postimplant dosimetry for low-dose-rate prostate seed brachytherapy to local control rates. The delineation of the prostate on CT images, however, represents a challenge due to the lack of soft-tissue contrast to identify the prostate borders. This study aims at quantifying the sensitivity of prostate V100 and D90 to contouring uncertainty as clinically relevant parameters for evaluation of target coverage in postimplant dosimetry. ⋯ Evaluation of a plan coverage based on V100 is too sensitive to systematic contouring errors of prostate. D90 increases the accuracy of CT-based postimplant quality assurance in identifying plans with insufficient coverage compared with V100.