Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy.

摘要: Abstract Purpose To compare the outcomes of patients with intermediate risk prostate cancer (IR-PCa) treated low-dose rate I-125 seed brachytherapy (LDR-BT) and targeted dose painting a histologic dominant intra-epithelial lesion (DIL) to those without DIL. Methods 455 IR-PCa were at single center intra-operatively planned LDR-BT, each following same in-house constraints. Patients DIL on pathology had hot spots localized that region but no specific contouring during procedure. Results 396 (87%) Baseline tumor characteristics overall dosimetry similar between except median number biopsy cores taken: 10 (10–12) vs 12 (p = 0.002). 19 (5%) 18 1 (2%) 0 (0%) experienced CTCAE grade 2 3 toxicity respectively. Overall, did not significantly correlate presence 0.10). Estimated 7-year freedom from biochemical failure (FFBF) was 84% (95% confidence interval: 79–89) 70% (54–89) in (log-rank p 0.315). In patients, cox regression revealed location (“Base” “Apex” HR: 1.03; 1.00–1.06; 0.03) older age (70 60 1.62; 1.06–2.49; associated poor FFBF. Conclusions Targeting through intraoperatively LDR-BT provided statistically significant change DILs base slightly lower FFBF despite boost.