Inada Masahiro, Yokokawa Masaki, Minami Takafumi, Nakamatsu Kiyoshi, Nishimura Yasumasa
Department of Radiation Oncology.
Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan.
J Contemp Brachytherapy. 2017 Oct;9(5):410-417. doi: 10.5114/jcb.2017.70902. Epub 2017 Oct 19.
The aim of this study was to compare the implant quality between intraoperatively built custom-linked seeds (IBCL) and loose seeds (LS) retrospectively.
This study included 74 prostate cancer patients who were treated with permanent prostate brachytherapy (PPB) using IBCL ( = 37) or LS ( = 37) between July 2014 and June 2016. Dose-volume histogram (DVH) parameters, seed migration, and operation time were compared between the IBCL and LS groups. In addition to the standard target volume of the whole prostate gland, DVH parameters for prostate plus a 3 mm margin (CTV) were evaluated.
In intraoperative planning, prostate V was lower (54.8% vs. 59.6%, = 0.027), and CTV V (88.1% vs. 85.6%, = 0.019) and D (98.5% vs. 92.6%, = 0.0033) were higher in the IBCL group compared with in the LS group. In post-implant dosimetry, prostate V (96.9% vs. 95.2%, = 0.020), CTV V (85.6% vs. 81.7%, = 0.046), and CTV D (94.2% vs. 86.5%, < 0.001) were higher, and prostate V (57.1% vs. 64.5%, = 0.0051) and CTV V (31.5% vs. 35.7%, = 0.046) were lower in the IBCL group compared with in the LS group. Regarding DVH changes between intraoperative planning and post-implant dosimetry, the decrease in prostate D was significantly lower in the IBCL group than in the LS group (-1.16% vs. -4.17%, < 0.001). For the IBCL group, the operation time was slightly but significantly longer than that for the LS group (50.5 minutes vs. 43.7 minutes, = 0.011). However, the seed migration rate was significantly lower in the IBCL group than in the LS group (5% vs. 41%, < 0.001).
Intraoperatively built custom-linked is more advantageous than LS in terms of dosimetric parameters and migration.
本研究旨在回顾性比较术中制作的定制连接籽源（IBCL）与松散籽源（LS）之间的植入质量。
本研究纳入了74例前列腺癌患者，这些患者在2014年7月至2016年6月期间接受了使用IBCL（n = 37）或LS（n = 37）的永久性前列腺近距离放射治疗（PPB）。比较了IBCL组和LS组之间的剂量体积直方图（DVH）参数、籽源迁移情况及手术时间。除了整个前列腺腺体的标准靶体积外，还评估了前列腺加3 mm边缘（临床靶体积，CTV）的DVH参数。
在术中规划中，IBCL组的前列腺V较低（54.8%对59.6%，P = 0.027），而CTV的V（88.1%对85.6%，P = 0.019）和D（98.5%对92.6%，P = 0.0033）高于LS组。在植入后剂量测定中，IBCL组的前列腺V（96.9%对95.2%，P = 0.020）、CTV的V（85.6%对81.7%，P = 0.046）和CTV的D（94.2%对86.5%，P < 0.001）较高，而前列腺的V（57.（此处原文可能有误，推测为57.1%）对64.5%，P = 0.0051）和CTV的V（31.5%对35.7%，P = 0.046）低于LS组。关于术中规划与植入后剂量测定之间的DVH变化，IBCL组前列腺D的下降明显低于LS组（-1.16%对-4.17%，P < 0.001）。对于IBCL组，手术时间略长但显著长于LS组（50.5分钟对43.7分钟，P = 0.011）。然而，IBCL组中的籽源迁移率显著低于LS组（5%对41%，P < 0.001）。
在剂量测定参数和迁移方面，术中制作的定制连接籽源比松散籽源更具优势。
