[OA088] Prostate HDR brachytherapy: the experience of the team matters. (August 2018)
- Record Type:
- Journal Article
- Title:
- [OA088] Prostate HDR brachytherapy: the experience of the team matters. (August 2018)
- Main Title:
- [OA088] Prostate HDR brachytherapy: the experience of the team matters
- Authors:
- Carrara, Mauro
Giandini, Tommaso
Tenconi, Chiara
Cerrotta, Annamaria
Fallai, Carlo
Pignoli, Emanuele - Abstract:
- Abstract : Purpose: To evaluate the learning curve of the BT- team performing prostate HDR brachytherapy (BT) at our Institution. Methods: Since 2010, 108 prostate BT treatments were performed at our Institution by the same BT- team (2 Radiation Oncologists, 2 Medical Physicists), using transrectal ultrasound-guided real time treatment planning. To evaluate the learning curve of the BT- team, Dose Homogeneity Index (DHI) and Conformity Index (COIN) were evaluated. According to the experienced treatment planning difficulties, a new index called Optimal Plan Index (OPI) was also established and evaluated. OPI was defined as the dose to 95% of the prostate (D95%) divided by the dose to 0.1 cc of the urethra (D0.1 cc). The prescribed dose ( D prescr ) was 14 Gy to the prostate surface and the most difficult planning goals were: D95% > 95% D prescr and D0.1 cc < 115% D prescr . The number of needles used for the procedure was also investigated. Results: DHI and COIN didn't show any correlation with the increasing experience of the BT team, whereas OPI resulted to be a good indicator of the learning curve. Average OPI values and number of needles used for the procedure, calculated for every group of 27 patients taken in chronological order, were 0.80 ± 0.05, 0.85 ± 0.06, 0.89 ± 0.03, 0.89 ± 0.02, and 17.6 ± 3.2, 19.4 ± 3.3, 17.2 ± 1.2, 16.8 ± 1.5, for group 1 (G1), 2 (G2), 3 (G3) and 4 (G4), respectively. OPI significantly increased with time (i.e., G1 vs G2 p < 0.001, G2 vs G3 pAbstract : Purpose: To evaluate the learning curve of the BT- team performing prostate HDR brachytherapy (BT) at our Institution. Methods: Since 2010, 108 prostate BT treatments were performed at our Institution by the same BT- team (2 Radiation Oncologists, 2 Medical Physicists), using transrectal ultrasound-guided real time treatment planning. To evaluate the learning curve of the BT- team, Dose Homogeneity Index (DHI) and Conformity Index (COIN) were evaluated. According to the experienced treatment planning difficulties, a new index called Optimal Plan Index (OPI) was also established and evaluated. OPI was defined as the dose to 95% of the prostate (D95%) divided by the dose to 0.1 cc of the urethra (D0.1 cc). The prescribed dose ( D prescr ) was 14 Gy to the prostate surface and the most difficult planning goals were: D95% > 95% D prescr and D0.1 cc < 115% D prescr . The number of needles used for the procedure was also investigated. Results: DHI and COIN didn't show any correlation with the increasing experience of the BT team, whereas OPI resulted to be a good indicator of the learning curve. Average OPI values and number of needles used for the procedure, calculated for every group of 27 patients taken in chronological order, were 0.80 ± 0.05, 0.85 ± 0.06, 0.89 ± 0.03, 0.89 ± 0.02, and 17.6 ± 3.2, 19.4 ± 3.3, 17.2 ± 1.2, 16.8 ± 1.5, for group 1 (G1), 2 (G2), 3 (G3) and 4 (G4), respectively. OPI significantly increased with time (i.e., G1 vs G2 p < 0.001, G2 vs G3 p < 0.01, G3 vs G4 p = 0.67) and number of needles significantly changed over time (i.e., G1 vs G2 p = 0.02, G2 vs G3 p = 0.005, G3 vs G4 p = 0.42), reaching both a plateau and a reduced statistical dispersion after about 50–60 treatments. In fact, within the first 50–60 treatments, some perfectible issues of the procedure were identified and improved (e.g., pre-treatment estimation of pubic arc obstruction, planned and achieved needle positions, dose optimization methods). Attendance of specific courses and conferences helped to achieve this task. Conclusions: The quality of HDR prostate BT is operator dependent and the proposed optimal plan index OPI is a good indicator of the learning curve of a BT- team . OPI and needle analysis, combined with a specific education of the involved clinical personnel, was useful to improve some treatment planning strategies at our Institution. … (more)
- Is Part Of:
- Physica medica. Volume 52(2018)Supplement 1
- Journal:
- Physica medica
- Issue:
- Volume 52(2018)Supplement 1
- Issue Display:
- Volume 52, Issue 2018 (2018)
- Year:
- 2018
- Volume:
- 52
- Issue:
- 2018
- Issue Sort Value:
- 2018-0052-2018-0000
- Page Start:
- 35
- Page End:
- Publication Date:
- 2018-08
- Subjects:
- Medical physics -- Periodicals
Biophysics -- Periodicals
Biophysics -- Periodicals
Imagerie médicale -- Périodiques
Radiothérapie -- Périodiques
Rayons X -- Sécurité -- Mesures -- Périodiques
Physique -- Périodiques
Médecine -- Périodiques
610.153 - Journal URLs:
- http://www.sciencedirect.com/science/journal/11201797 ↗
http://www.clinicalkey.com/dura/browse/journalIssue/11201797 ↗
http://www.clinicalkey.com.au/dura/browse/journalIssue/11201797 ↗
http://www.elsevier.com/journals ↗
http://www.physicamedica.com ↗ - DOI:
- 10.1016/j.ejmp.2018.06.160 ↗
- Languages:
- English
- ISSNs:
- 1120-1797
- Deposit Type:
- Legaldeposit
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- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 6475.070000
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