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AbstractAbstract
[en] Purpose: To establish dosimetry guidelines to minimize urethral and rectal morbidity following permanent I-125 prostatic brachytherapy. Methods and Materials: Dosimetric parameters were correlated with long-term morbidity for 65 patients following transperineal I-125 implantation for Stage (T1(T2)) prostatic carcinoma. The prescribed minimum prostatic dose was 150 Gy. The median total activity used was 48 mCi (range: 32-77 mCi). Patients were followed for 1-5 years (median follow-up: 2 years). Postimplant computerized tomography (CT)-based dosimetry was performed for 45 patients. Morbidity was evaluated using a modification of the RTOG grading system, with a scale of grade 0-5. Results: The incidence of grades 2 and 3 urinary morbidity was associated with the maximum central urethral dose (p = 0.03), and with the length of urethra that received greater than 400 Gy (p = 0.07). Patients with larger prostates had more long-term urinary morbidity (p = 0.06). Rectal bleeding (RTOG grade 1) or ulceration (RTOG grade 2) was associated with irradiation of the rectal wall to doses in excess of 100 Gy (p = 0.02). There was no relationship between the matched peripheral dose (MPD), mCi/source or total mCi implanted and long-term morbidity. Conclusions: Postimplant, CT-based dosimetry can predict which patients are at higher risk of radiation-related morbidity. More simplistic parameters including the MPD, total activity implanted, or mCi/source, had no relationship with morbidity. To decrease the risk of long-term morbidity, an effort should be made to keep the central urethral dose below 400 Gy, and the rectal surface dose below 100 Gy
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Source
Copyright (c) 1995 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Record Type
Journal Article
Journal
International Journal of Radiation Oncology, Biology and Physics; ISSN 0360-3016;
; CODEN IOBPD3; v. 32(2); p. 465-471

Country of publication
BETA DECAY RADIOISOTOPES, BIOLOGICAL EFFECTS, BIOLOGICAL RADIATION EFFECTS, BODY, DAYS LIVING RADIOISOTOPES, DIAGNOSTIC TECHNIQUES, DIGESTIVE SYSTEM, DISEASES, ELECTRON CAPTURE RADIOISOTOPES, GASTROINTESTINAL TRACT, GLANDS, INJURIES, INTERMEDIATE MASS NUCLEI, INTERNAL CONVERSION RADIOISOTOPES, INTESTINES, IODINE ISOTOPES, ISOTOPES, LARGE INTESTINE, MALE GENITALS, MEDICINE, NEOPLASMS, NUCLEAR MEDICINE, NUCLEI, ODD-EVEN NUCLEI, ORGANS, PATHOLOGICAL CHANGES, RADIATION EFFECTS, RADIOISOTOPES, RADIOLOGY, SAFETY STANDARDS, STANDARDS, THERAPY, TOMOGRAPHY
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