Brachytherapy
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Randomized Controlled Trial Clinical Trial
Factors predictive of rectal bleeding after 103Pd and supplemental beam radiation for prostate cancer.
To evaluate the contribution of various clinical and radiation treatment parameters to the likelihood of late rectal bleeding after brachytherapy plus supplemental beam radiation (EB). ⋯ Considering the potential severity of rectal morbidities and their relationship to implant dose, we urge our colleagues to routinely monitor the rectal implant doses of their own patients to make sure that such doses are kept within an accepted range.
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To evaluate the effect of hormonal manipulation on catheter dependency, the resolution of urinary symptomatology, and the need for postbrachytherapy transurethral/transincisional resection (TURP/TUIP). ⋯ In this retrospective evaluation, hormonal manipulation did not statistically impact short-term or prolonged urinary catheter dependency or I-PSS at 18 months, but did influence time to I-PSS normalization and the need for postbrachytherapy surgical intervention.
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Comparative Study
Migration of implanted free radioactive seeds for adenocarcinoma of the prostate using a Mick applicator.
This study investigates the rate of free seed migration and associated seed-related sequelae after using a radioimmunoguided Mick applicator technique to place radioactive seeds within the prostate. ⋯ The rate of seed emboli to the pulmonary vessels or to other tissue localities resulting from a radioimmunoguided Mick applicator technique does not appear to be markedly different from the reported rate seen with other free seed techniques.
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Quality assurance through postplan assessment is an integral part of permanent seed prostate implants. The use of MRI-CT fusion for 1-month postimplant dosimetry permits accurate assessment of prostate volume without seed induced artifact and uncertainties of prostate contour inherent to CT assessments. Routine use of MRI-CT fusion reveals significant prostate edema may persist several weeks. This study evaluates the effect of edema, and its subsequent resolution, on dosimetry. ⋯ Significant residual edema is seen 1-month postimplant in 12% of prostates and may have a profound effect on dosimetry. Further study is underway to characterize the time course of resolution of the edema, and to perform integral dosimetry based on the changing volume.