Brachytherapy
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Adjuvant partial breast radiotherapy is the standard of care for early-stage favorable breast cancer. We report dosimetry, acute and late tolerance for 67 permanent breast seed implants. ⋯ Our experience with permanent breast seed implant is favorable with a high patient acceptance and satisfaction, excellent early efficacy, and very satisfactory cosmesis.
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Pulmonary seed emboli to the chest may occur after permanent prostate brachytherapy (PPB). The purpose of this study is to analyze factors associated with seed migration to the chest in a large series of PPB patients from a single institution undergoing implant with either loose seeds (LS), mixed loose and stranded seeds (MS), or exclusively stranded seeds in an absorbable vicryl suture (VS). ⋯ In this large series, significantly higher rates of seed migration to the chest are observed in implants using any LS with observed hazard ratios of 15.9 and 7.9 for LS and MS respectively, as compared with implants using solely stranded seeds.
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The purpose of this study was to study the correlation between intraoperative and postimplant dosimetry. We investigated the correlation between prostate (V150) and urethra (D30, D5) dose limits, and whether it is possible to increase prostate D90 and V100 in intraoperative planning without violating postimplant urethra and rectum dose limits. ⋯ Intraoperative implant dosimetry could not accurately predict postimplant dosimetry; however, to avoid underdosage of prostate, intraoperative D90 should be close to 120% of prescribed dose and V100 needs to be close to 100% of prescribed dose. Prostate V150> 50% does not necessarily indicate the violation of urethra D30 and D5 dose limits. For most of the implants, target intraoperative D90 and V100 could be raised without violating urethra D30 and D5 limits recommended by American Brachytherapy Society in postimplant evaluation.
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To evaluate the effect of metabolic parameters of pretreatment primary tumor and regional lymph nodes with F-18-FDG PET/CT compared with MRI findings for the prognostic value and disease-free survival (DFS) in locally advanced cervical cancer. ⋯ As a result, FDG PET/CT has higher accuracy than MRI in detecting lymph node metastasis, and tumor volume reduction on FDG PET/CT images was greater than that on MRI images after CCRT.
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Randomized Controlled Trial
Using a surgical prostate-specific antigen threshold of >0.2 ng/mL to define biochemical failure for intermediate- and high-risk prostate cancer patients treated with definitive radiation therapy in the ASCENDE-RT randomized control trial.
To compare biochemical failure using a prostate-specific antigen (PSA) threshold of >0.2 ng/mL to that using Phoenix threshold (nadir+2 ng/mL). ⋯ Replacing Phoenix with a surgical threshold greatly increased biochemical failure after DE-EBRT boost but had no effect after LDR-PB. As a result of this finding, PSA outcomes after surgery or brachytherapy can be directly compared by using the surgical definition of PSA failure. In this context, a brachytherapy boost appears to produce superior b-PFS compared to contemporary surgical series.