NYPI PUBLICATIONS
Long-term Multi-Institutional Outcome and biochemical Failure Definition Analysis of Combined Permanent Brachytherapy With External Beam Radiation for Prostate Cancer
- M. A. Elshaikh1, D. Kuban2, L. Levy2, L. Potters3, J. Blasko4, D. Beyer5, A. Zietman6, B. J. Moran7, J. Ciezki8, M. J. Zelefsky9, et al. 1University of Michigan, Ann Arbor, MI, 2University of Texas MD Anderson Cancer Center, Houston, TX, 3New York Prostate Institute, Oceanside, NY, 4Seattle Prostate Institute, Seattle, WA, 5Arizona Oncology Services, Scottsdale, AZ, 6Massachusetts General Hospital, Boston, MA, 7Chicago Prostate Institute, Chicago, IL, 8Cleveland Clinic Foundation, Cleveland, OH, 9Memorial Sloan Kettering Cancer Center, New York, NY
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Customized Dose Prescription for Prostate Brachytherapy: Insights From a Multicenter Analysis of Dosimetry Outcomes
- N. N. Stone1, L. Potters2, B. J. Davis3, J. P. Ciezki4, M. J. Zelefsky5, M. Roach6, P. A. Fearn5, M. W. Kattan7, R. G. Stock1 1Mount Sinai School of Medicine, New York, NY, 2New York Prostate Institute at South Nassau Communities Hospital, Oceanside, NY, 3Mayo Clinic, Rochester, MN, 4Cleveland Clinic, Cleveland, OH, 5Memorial Sloan Kettering CancerCenter, New York, NY, 6University of California at San Francisco, San Francisco, CA, 7Cleveland Clinic Foundation,Cleveland, OH
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An Updated 9-Year Preoperative Nomogram Predicting for Prostate Cancer Recurrence After Permanent Prostate Brachytherapy
- M. W. Kattan1, R. G. Stock2, J. P. Ciezki3, B. J. Davis4, M. J. Zelefsky5, M. Roach6, N. N. Stone2, P. A. Fearn5, L. Potters7. 1Cleveland Clinic Foundation, Cleveland, OH, 2Mount sinai School of Medicine, New York, NY, 3Cleveland Clinic,Cleveland, OH, 4Mayo Clinic, Rochester, MN, 5Memorial Sloan Kettering Cancer Center, New York, NY, 6University of california at San Francisco, San Francisco, CA, 7New York Prostate Institute at South Nassau Communities Hospital, Oceanside, NY
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The Post-Treatment PSA Bounce for Prostate Cancer Patients Treated With External Beam RT or Permanent Brachytherapy Alone Is Not Biochemically or Clinically Significant: A Multi-Institutional Pooled A
- E. M. Horwitz1, L. B. Levy2, A. A. Martinez3, L. Potters4, D. C. Beyer5, J. C. Blasko6, H. M. Sandler7, S. J. Buskirk8, A. L. Zietman9, D. A. Kuban2. 1Fox Chase Cancer Center, Philadelphia, PA, 2M.D. Anderson Cancer Center, Houston, TX, 3William Beaumont Hospital, Royal Oak, MI, 4New York Prostate Institute, Oceanside, NY, 5Arizona Oncology Services, Scottsdale, AZ, 6Seattle Prostate Institute, Seattle, WA, 7University of Michigan, Ann Arbor, MI, 8Mayo Clinic College of Medicine, Jacksonville, FL,9Massachusetts General Hospital, Boston, MA
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Postoperative Nomogram Predicting the 9-Year Probability of Prostate Cancer Recurrence After Permanent Prostate Brachytherapy
- L. Potters1, R. G. Stock2, J. P. Ciezki3, B. J. Davis4, M. J. Zelefsky5, M. Roach6, N. N. Stone2, P. A. Fearn5, M. W. Kattan7. 1New York Prostate Institute at South Nassau Communities Hospital, Oceanside, NY, 2Mount Sinai School of Medicine, New York, NY, 3Cleveland Clinic, Cleveland, OH, 4Mayo Clinic, Rochester, MN, 5Memorial Sloan Kettering Cancer Center, New York, NY, 6University of California at San Francisco, San Francisco, CA, 7Cleveland Clinic Foundation, Cleveland, OH
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Purpose: To evaluate dosimetry and source location relative to CT-based dosimetry when performingreal-time dynamic permanent prostate brachytherapy (PPB) with inverse treatment planning.
Methods and Materials: A treatment algorithm for dynamic PPB was developed using inverse treatment planning. The technique utilizes real-time transrectal ultrasound prostate imaging connected to the treatment planning software. The implementation of the plan with the Mick interstitial gun is monitored with up-to-date dosimetry assessments based on the registration of each seed when placed. Real-time dose assessment is monitored and adjustments can be made during the case, if necessary. A final OR dosimetric (OR-D) assessment based on the registered seed locations is performed. Post-op CT scans obtained at 3 weeks are used for traditional dosimetry analysis (CT-D). A matrix algorithm was developed to match the seed locations from the ultrasound registration to that of the CT-scan parameters.
Results: Twenty-six consecutive patients with clinically localized prostate cancer underwent PPB using the algorithm designed for dynamic real-time planning. The OR-D identified a mean D90 of 109% (range 100-118%) whereas the mean CT-D D90 at 3 weeks was 105% (range 89-122%) (p _ 0.894). Analysis of the OR-D V100 and V150 relative to the 3-week CT-dose V100 and V150 were also insignificant (p _ 0.112 and 0.167, respectively). Assessment of seed locations relative to the intra-op ultrasound and postimplant CT identified a mean root-mean-square error of 4.6 mm (0,21 mm). The mean error for the x, y, and z coordinates were 2.01 mm, 2.24 mm, and 2.85 mm, respectively.
Conclusions: This study reports the preliminary results of a new treatment algorithm for PPB that incorporates intraoperative inverse planning with dynamic dosimetry assessment during the case. Correlation was seen between the completed intraoperative, postimplant plan and the CT based plan at 3 weeks. Seed to seed deviations between the OR-D matched well with the CT-D. Additional study is necessary to assess whether this approach can assist in improving implant dosimetry andwhether it appropriately documents the OR-dose without the need for post-implant dosimetry.
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