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68 Preliminary results of intersticial HDR brachytherapy in association with conservative surgery for soft tissue sarcomas
s17
66
65 lll)l<
Nl:U’I‘RON
(‘AN(‘I
IN
VAtkocius I.ithuanian
I~RA(‘lIYTI
A.Burneckis Oncology
in
fractions
that
cxtcrnal
dose
4W45
therapy.
the
[IDR
combined
cancer.The
physical
(‘f-252
radiation treatment
trajectory)
week.
2
hcam Gy
of the Cf.252
radiation
patients
therapy
completed
per
thrrapy
for
at the
dose
with interval
cx~ernal fraction)
hrachythcrapy is
continued
the
proposed
The results of this trial
and
Ncutron
schedule:two
brachytherapy(5Gy-cq
per
beam Gy.Six
analyst
the
of the photon
, two fractions
A.J.M Wopereis, M.A. Moerland, J.H.A.G. de Kotig and J.J. Battermamt, University Hospital Utrecht, Depattment of Radiotherapy, The Netherlands
Lithuania
to
source movement
S-8 fractions
therapy(5
is of
the
prostatic
of the Cf.252
point 2 cm from
radiatlon
report
boost
advanced
prostate
Vilnius
hackground
hrachytherapy
hours;
LOSS OF I-125 SEEDS AFTER PERINEAL IMPLANTATION OF THE PROSTATE 63
I’ROSTATI(
V.Lazutka
(‘enter,
of this
radiobiological
fractions
FOR
I.I’I‘IIUANIA
The purpose
locally
Il:RAPY
will
24
radiation the
to
and after till
total
combined
he discussed.
67 BRACHYTHERAPY IN THE CONSERVATIVE TREATMENT OF SOFT TISSUE SARCOMAS EXTENDING TO NEUROVASCULAR STRUCTURES : AN ANALYSIS OF 38 CASES. L. Thomas’, M. Delannes”, E. Stockle’, P. Martel”. J. Ptgneux’, N. Daly-Schveitzer”, B.N. Bui’, C. Chevreau”, G. Kantor’ . Insfrf~tBergome. RegwnalcancerCenter. Bordeaux,France *. Centre ClaudiusRegaud,RegionalCancerCenter. Toulouse. France
To evaluate the tolerance of neurovascuiar structures to brachytherapy, a retrospective review of our series was undertaken. Between May 1986 and January 1994, 85 patients with soft tissue sarcomas underwent conservative surgery and low-dose rate interstitial irradiation. Thirty-eight patients had tumors extending to neurovascular structures. Brachytherapy was part of initial treatment in 30 patients and was done in 7 cases for recurrent sarcomas. Afterloading catethers for brachytherapy were inserted intraoperatively and placed direct upon or under the neurovascular structures in the tumor bed. A mean dose of 20 Gv was delivered to the taroet volume. Thirtv oatients received 45 to 50 Gy of postoperatyve external irradiadon. With a median follow-up of 39 months, the 3-year actuarial survival was 82.9%, the 3-year disease-free survival was 71.9% and the 3-year actuarial local control was 91%. The 3-year actuarial incidence of distant metastase was 28%. Acute side effects occurred in 12 patients requiring conservatrve suraical orocedures in 6 cases. Sianificant late toxicitv occurred in
Introduction: One of the treatment modalities of early stage prostate cancer is the permanent implantation of I- 125 seeds. The aim of this study was to obtain insight in the loss of seeds after implantation. Methods and Materials: During the past 6 years, 100 patients were treated and examined. Radiographs ,of the prostate area were taken at discharge (atIer 2 or 3 days) and combined with a follow-up appointment, successively after I, 3, 6, 12 and 24 months. IO patients were excLded 6om this study because of a later performed prostatectomy or TURP. During the hospitalisation period the patient’s excrements were examined for lost seeds. Furthermore patients were instructed to urinate through a tea-strainer in the first month following implantation in order to prevent seeds from entering the sewege system. w: We observed an overall loss of 5% during the entire followup period of 2 years. Further analysis of the obtained data showed that most of the seeds (3% of the implanted seeds) were lost in the first 2 days afier implantation. Due to special attention paid to safety measures, 94% of the lost seeds were retrieved during the admission period. Because of adequate instructions given to the patients, 70% of tbe seeds lost during tbe first month after discharge (0.5% of the total number of remaining implanted seeds) were also retrieved. Losing seeds during the first month after implantation did not increase the chance of further loss later on. A total of I3 seeds (in all patients) was lost after 1 month (of which 6 were lost after more then one year and are for radiation safety reasons not of importance). Conclusions: Most seeds are lost during the first days afler implantation. Therefore, radiographs are indicated at discharge, after I month (for evaluation of safety precautions) and after I year as a conclusion to the treatment.
66
65 lll)l<
Nl:U’I‘RON
(‘AN(‘I
IN
VAtkocius I.ithuanian
I~RA(‘lIYTI
A.Burneckis Oncology
in
fractions
that
cxtcrnal
dose
4W45
therapy.
the
[IDR
combined
cancer.The
physical
(‘f-252
radiation treatment
trajectory)
week.
2
hcam Gy
of the Cf.252
radiation
patients
therapy
completed
per
thrrapy
for
at the
dose
with interval
cx~ernal fraction)
hrachythcrapy is
continued
the
proposed
The results of this trial
and
Ncutron
schedule:two
brachytherapy(5Gy-cq
per
beam Gy.Six
analyst
the
of the photon
, two fractions
A.J.M Wopereis, M.A. Moerland, J.H.A.G. de Kotig and J.J. Battermamt, University Hospital Utrecht, Depattment of Radiotherapy, The Netherlands
Lithuania
to
source movement
S-8 fractions
therapy(5
is of
the
prostatic
of the Cf.252
point 2 cm from
radiatlon
report
boost
advanced
prostate
Vilnius
hackground
hrachytherapy
hours;
LOSS OF I-125 SEEDS AFTER PERINEAL IMPLANTATION OF THE PROSTATE 63
I’ROSTATI(
V.Lazutka
(‘enter,
of this
radiobiological
fractions
FOR
I.I’I‘IIUANIA
The purpose
locally
Il:RAPY
will
24
radiation the
to
and after till
total
combined
he discussed.
67 BRACHYTHERAPY IN THE CONSERVATIVE TREATMENT OF SOFT TISSUE SARCOMAS EXTENDING TO NEUROVASCULAR STRUCTURES : AN ANALYSIS OF 38 CASES. L. Thomas’, M. Delannes”, E. Stockle’, P. Martel”. J. Ptgneux’, N. Daly-Schveitzer”, B.N. Bui’, C. Chevreau”, G. Kantor’ . Insfrf~tBergome. RegwnalcancerCenter. Bordeaux,France *. Centre ClaudiusRegaud,RegionalCancerCenter. Toulouse. France
To evaluate the tolerance of neurovascuiar structures to brachytherapy, a retrospective review of our series was undertaken. Between May 1986 and January 1994, 85 patients with soft tissue sarcomas underwent conservative surgery and low-dose rate interstitial irradiation. Thirty-eight patients had tumors extending to neurovascular structures. Brachytherapy was part of initial treatment in 30 patients and was done in 7 cases for recurrent sarcomas. Afterloading catethers for brachytherapy were inserted intraoperatively and placed direct upon or under the neurovascular structures in the tumor bed. A mean dose of 20 Gv was delivered to the taroet volume. Thirtv oatients received 45 to 50 Gy of postoperatyve external irradiadon. With a median follow-up of 39 months, the 3-year actuarial survival was 82.9%, the 3-year disease-free survival was 71.9% and the 3-year actuarial local control was 91%. The 3-year actuarial incidence of distant metastase was 28%. Acute side effects occurred in 12 patients requiring conservatrve suraical orocedures in 6 cases. Sianificant late toxicitv occurred in
Introduction: One of the treatment modalities of early stage prostate cancer is the permanent implantation of I- 125 seeds. The aim of this study was to obtain insight in the loss of seeds after implantation. Methods and Materials: During the past 6 years, 100 patients were treated and examined. Radiographs ,of the prostate area were taken at discharge (atIer 2 or 3 days) and combined with a follow-up appointment, successively after I, 3, 6, 12 and 24 months. IO patients were excLded 6om this study because of a later performed prostatectomy or TURP. During the hospitalisation period the patient’s excrements were examined for lost seeds. Furthermore patients were instructed to urinate through a tea-strainer in the first month following implantation in order to prevent seeds from entering the sewege system. w: We observed an overall loss of 5% during the entire followup period of 2 years. Further analysis of the obtained data showed that most of the seeds (3% of the implanted seeds) were lost in the first 2 days afier implantation. Due to special attention paid to safety measures, 94% of the lost seeds were retrieved during the admission period. Because of adequate instructions given to the patients, 70% of tbe seeds lost during tbe first month after discharge (0.5% of the total number of remaining implanted seeds) were also retrieved. Losing seeds during the first month after implantation did not increase the chance of further loss later on. A total of I3 seeds (in all patients) was lost after 1 month (of which 6 were lost after more then one year and are for radiation safety reasons not of importance). Conclusions: Most seeds are lost during the first days afler implantation. Therefore, radiographs are indicated at discharge, after I month (for evaluation of safety precautions) and after I year as a conclusion to the treatment.