Nag S, Bice W, DeWyngaert K, Prestidge B, Stock R, Yu Y
Clinical Research Committee, The American Brachytherapy Society, Oak Brook, IL, USA.
Int J Radiat Oncol Biol Phys. 2000 Jan 1;46(1):221-30. doi: 10.1016/s0360-3016(99)00351-x.
The purpose of this report is to establish guidelines for postimplant dosimetric analysis of permanent prostate brachytherapy.
Members of the American Brachytherapy Society (ABS) with expertise in prostate dosimetry evaluation performed a literature review and supplemented with their clinical experience formulated guidelines for performing and analyzing postimplant dosimetry of permanent prostate brachytherapy.
The ABS recommends that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy for optimal patient care. At present, computed tomography (CT)-based dosimetry is recommended, based on availability cost and the ability to image the prostate as well as the seeds. Additional plane radiographs should be obtained to verify the seed count. Until the ideal postoperative interval for CT scanning has been determined, each center should perform dosimetric evaluation of prostate implants at a consistent postoperative interval. This interval should be reported. Isodose displays should be obtained at 50%, 80%, 90%, 100%, 150%, and 200% of the prescription dose and displayed on multiple cross-sectional images of the prostate. A dose-volume histogram (DVH) of the prostate should be performed and the D90 (dose to 90% of the prostate gland) reported by all centers. Additionally, the D80, D100, the fractional V80, V90, V100, V150 and V200 (i.e., the percentage of prostate volume receiving 80%, 90%, 100%, 150%, and 200% of the prescribed dose, respectively), the rectal, and urethral doses should be reported and ultimately correlated with clinical outcome in the research environment. On-line real-time dosimetry, the effects of dose heterogeneity, and the effects of tissue heterogeneity need further investigation.
It is essential that postimplant dosimetry should be performed on all patients undergoing permanent prostate brachytherapy. Guidelines were established for the performance and analysis of such dosimetry.
本报告旨在制定永久性前列腺近距离放射治疗植入后剂量学分析的指南。
美国近距离放射治疗学会（ABS）中在前列腺剂量学评估方面具有专业知识的成员进行了文献综述，并结合他们的临床经验，制定了永久性前列腺近距离放射治疗植入后剂量学的执行和分析指南。
ABS建议对所有接受永久性前列腺近距离放射治疗的患者进行植入后剂量学分析，以实现最佳的患者护理。目前，基于可用性、成本以及对前列腺和种子进行成像的能力，推荐采用基于计算机断层扫描（CT）的剂量学方法。应获取额外的平面X线片以核实种子数量。在确定理想的术后CT扫描间隔之前，每个中心应在一致的术后间隔时间对前列腺植入物进行剂量学评估。应报告此间隔时间。应获取处方剂量50%、80%、90%、100%、150%和200%的等剂量显示，并显示在前列腺的多个横断面图像上。应进行前列腺的剂量体积直方图（DVH）分析，所有中心均应报告D90（前列腺90%体积所接受的剂量）。此外，还应报告D80、D100、分数V80、V90、V100、V150和V200（即分别接受处方剂量80%、90%、100%、150%和200%的前列腺体积百分比）、直肠和尿道剂量，并最终在研究环境中与临床结果相关联。在线实时剂量学、剂量不均匀性的影响以及组织不均匀性的影响需要进一步研究。
对所有接受永久性前列腺近距离放射治疗的患者进行植入后剂量学分析至关重要。已制定了此类剂量学的执行和分析指南。
