Brachytherapy
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The objective of the survey was to obtain detailed information on the use of brachytherapy through a web-based questionnaire. The present article describes the resources available in 2002. ⋯ Notable differences in brachytherapy treatment were observed, especially in the workload of radiation oncologists and physicists in Groups II and III, the two groups with largest number of patients. New surveys can provide a detailed analysis of changes over time, a potentially useful tool to eliminate the differences observed.
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To assess the correlation of postimplant dosimetric quantifiers with biochemical control of prostate cancer after low-dose-rate brachytherapy. ⋯ In our series of 140 patients with low-risk prostate cancer treated with LDRPB alone, we observed a statistically significant correlation between EUD, D(90), and V(100) and bRFS. The generalized EUD, a calculated value that incorporates the entire prostate DVH, appears to be at least as well correlated with bRFS as D(90) or V(100), and may more completely represent the totality of the dose distribution.
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To report the acute and late treatment-related toxicities of combined permanent interstitial (125)I implantation delivered via real-time intraoperative planning and supplemental intensity-modulated radiotherapy (IMRT) for patients with clinically localized prostate cancer. ⋯ Adherence to dose constraints with combination real-time brachytherapy using real-time intraoperative planning and IMRT is associated with a low incidence of acute and late toxicities. Acute urinary side effects were significantly less common for CM patients compared to those treated with implantation alone. Late Grade 2 rectal and urinary toxicities were more common for patients treated with CM compared to implant alone.
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To evaluate lumpectomy followed by interstitial brachytherapy as an acceptable salvage therapy for women who have developed localized recurrence of breast cancer after conservation surgery and postoperative external radiotherapy. ⋯ Repeat lumpectomy followed by brachytherapy is feasible and may be an acceptable alternative to salvage mastectomy in patients who locally fail conservation breast therapy; however, longer followup and greater patient numbers may be needed to better define the role of salvage brachytherapy.
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Intracavitary high-dose-rate (HDR) brachytherapy (BT) for cervical cancer involves multiple applicator insertions. Our study addresses whether customized three-dimensional plans generated for the first insertion (using computed tomography [CT] planning) can be applied to subsequent insertions without significant changes in dose distributions if identical applicators are used. ⋯ A duplication of planned dwell times and positions from one insertion to the next does not duplicate dose distributions in HDR cervix applications. A single plan used for an entire course of BT can result in significant increases to OAR doses for TR and unpredictable OAR doses for TO applicators. Treatment plans should be tailored for each insertion to reflect current applicator and anatomical geometry.