title: The effects of edema on urethral dose following palladium-103 prostate brachytherapy.
abstract: The effects of edema on urethral dose after interstitial prostate brachytherapy with palladium-103 (103Pd) were studied. Fifty patients underwent a 90-Gy 103Pd implant followed by dosimetric computed tomography (CT). Twenty-one days later, a Foley catheter was reinserted and a dosimetric CT was repeated. The mean reduction in prostate volume between day 0 and day 21 was 16%. Median prostate D90 on day 0 was 89.7 Gy (range 59.5 to 127) and 99.5 Gy (range 62.5 to 130) on day 21. Median prostate V100 was 90% (range 63 to 98%) on day 0 and 96% (range 66 to 99%) on day 21. Median V150 was 61% (range 31 to 85%) on day 0 and 75% (range 39 to 93%) on day 21. Median urethral D50 was 107 Gy (range 57 to 201) on day 0 and 126 Gy (range 64 to 193) on day 21. Regression analysis demonstrated a significant correlation between the decrease in the prostate volume and the increased urethral D50 (r 0.58, p < 0.05). Acute urinary toxicity was 32% grade 0, 38% grade 1, and 30% grade 2. The median urethral D50 increased by a mean of 18% with a correlation coefficient of 0.58 (p < 0.05). Catheterization of the urethra was well tolerated and was of value in better characterizing urethral dose after 103Pd brachytherapy.
authors.affiliation: Department of Radiation Oncology, Hackensack University Medical Center, NJ 07601, USA. ggejerman@humed.com
authors.forename: Glen
authors.initials: G
authors.lastname: Gejerman
authors.forename: Eduard
authors.initials: E
authors.lastname: Mullokandov
authors.forename: A J
authors.initials: AJ
authors.lastname: Saini
authors.forename: Vincent
authors.initials: V
authors.lastname: Lanteri
authors.forename: John
authors.initials: J
authors.lastname: Scheuch
authors.forename: Jack
authors.initials: J
authors.lastname: Vitenson
authors.forename: Jay
authors.initials: J
authors.lastname: Rosen
authors.forename: Richard
authors.initials: R
authors.lastname: Garden
authors.forename: Ihor
authors.initials: I
authors.lastname: Sawczuk
mesh_terms: D001918:Brachytherapy / Q000009:adverse effects*; D004307:Dose-Response Relationship, Radiation; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D010165:Palladium / Q000008:administration & dosage* / Q000009:adverse effects*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011868:Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014521:Urethra / Q000000981:diagnostic imaging / Q000528:radiation effects*; D014522:Urethral Diseases / Q000000981:diagnostic imaging / Q000209:etiology*
chemical_list: D011868:Radioisotopes; D010165:Palladium