Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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To report the dosimetric outcome of patients with clinically localized prostate cancer treated with I-125 permanent implantation using an intraoperative real-time conformal planning technique. ⋯ Real-time intraoperative planning was associated with a 90% consistency of achieving the planned intraoperative dose constraints for target coverage and maintaining planned urethral and rectal constraints in a high percentage of implants. Rectal volumes of >or=2.5 cm(3) exposed to the prescription doses were associated with an increased incidence of grade 2 rectal bleeding. Further enhancements in imaging guidance for optimal seed deposition are needed to guarantee optimal dose distribution for all patients. Whether such improvements lead to further reduction in acute and late morbidities associated with therapy requires further study.
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To report on: 1. Late radiotherapy-induced lower intestinal toxicity (RILIT) after intensity-modulated radiotherapy (IMRT) for prostate cancer. 2. The correlation between late RILIT and volume parameters of the rectum, sigmoid colon and small bowel. ⋯ After IMRT for prostate cancer, the overall incidence of grade >or=2 RILIT is low. Cut-off DVHs can be used for patient counseling.
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To report the treatment-related morbidity in patients with prostate cancer treated with an optimized pelvic intensity-modulated radiation therapy (IMRT) and simultaneous integrated dose escalation to prostate/prostate bed. ⋯ Pelvic IMRT and simultaneous dose escalation to prostate area is a well-tolerated technique in patients with prostate cancer requiring treatment of pelvic lymph nodes, and seems to be associated with a lower frequency and severity of side effects when compared with conventional techniques reported in other series.
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Comparative Study
Comprehensive I-125 multi-seed comparison for prostate brachytherapy: dosimetry and visibility analysis.
To compare the visibility of different manufacturers I-125, seeds, and to investigate the effect of differences in dosimetry on treatment planning. ⋯ The greatest changes to point dose occur at very close distances to the seeds. Changing seed type may require a treatment replan to maintain satisfactory DVH criteria. Visibility on US and CT is similar, though it may vary on MRI, X-ray and fluoroscopy.
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To prospectively evaluate long-term urinary, bowel and sexual function after I-125 brachytherapy for localised prostate cancer using patient administered validated Quality of Life (QoL) instruments. ⋯ After an initial period of mild to moderate urinary symptoms prostate brachytherapy is well tolerated with relatively little deterioration in long-term quality of life. Long-term reduction in sexual function may be seen particularly in those requiring hormones.