Correlating the degree of needle trauma during prostate brachytherapy and the development of acute urinary toxicity.
OBJECTIVE
To determine if there is an association between the degree of prostate trauma during prostate brachytherapy and development of acute urinary toxicity.


METHODS
In a consecutive prospective cohort of permanent (125)I prostate brachytherapy patients, the number of times each needle was repositioned was tracked, and the dosimetry plans were used to determine the number of times needles within 1 cm of the urethra were manipulated. Additionally, prostate volume, total number of needles, number of needles/prostate volume, and the number of periurethral needle manipulations/prostate volume were determined. The need for catheterization beyond 24 hours and the Radiation Therapy Oncology Group (RTOG) urinary toxicity score at 4 weeks were recorded. The independent samples t test was used to search for a correlation between these parameters and the recorded toxicity scores.


RESULTS
Twenty-eight consecutive implant patients were evaluated in the study. Median (range) values were as follows: prostate volume 35 cc ( range, 15-51 cc), number of needles per patient 32 (range, 21-41), number of needle manipulations per patient 94.5 ( range, 55-147), and number of periurethral needle manipulations 42 (range, 17-65). The only significant association between urinary toxicity and these variables was for the number of periurethral needle manipulations (p = 0.025).


CONCLUSIONS
These data provide evidence that needle prostate trauma during brachytherapy contributes to acute urinary toxicity.
Department of Radiation Oncology, Ottawa Hospital, Ottawa, Ontario K1H 1C4, Canada. libni.eapen@orcc.on.ca
Libni
L
Eapen
Cathy
C
Kayser
Yves
Y
Deshaies
Gad
G
Perry
Choan
C
E
Christopher
C
Morash
Joanna E
JE
Cygler
David
D
Wilkins
Simone
S
Dahrouge
D000208:Acute Disease; D001918:Brachytherapy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D006801:Humans; D008297:Male; D009339:Needles / Q000009:adverse effects*; D011446:Prospective Studies; D011467:Prostate / Q000293:injuries* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011677:Punctures / Q000009:adverse effects*; D016055:Urinary Retention / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology*