Intra-operative pubic arch interference during prostate seed brachytherapy in patients with CT-based pubic arch interference of ≤1 cm

Samir V. Sejpal, Vythialingam Sathiaseelan, Irene B. Helenowski, James M. Kozlowski, Michael F. Carter, Robert B. Nadler, Daniel P. Dalton, Kevin T. McVary, William W. Lin, John E. Garnett, John A. Kalapurakal*

*Corresponding author for this work

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

Purpose: There are only a few reports on the frequency of intra-operative pubic arch interference (I-PAI) during prostate seed brachytherapy (PB). Materials and methods: Two hundred and forty-three patients with a CT-based pubic arch interference (PAI) of ≤1 cm and a prostate volume of ≤50-60 cc underwent PB. Those patients requiring needle repositioning by ≥0.5 cm on the template were scored as having I-PAI. The incidence of I-PAI and its impact on biochemical control were analyzed. Results: Intra-operative PAI was encountered in 47 (19.3%) patients. Forty two patients (17.3%) had I-PAI in 1-2 needles, two (0.8%) had I-PAI in four needles and three patients (1.2%) had I-PAI in six needles. Overall, 1.4% of needles required repositioning due to I-PAI. BMI > 27 kg/m2 and wider (>75 mm) pubic bone separation at mid ramus (PS-ML) were associated with a lower incidence of I-PAI. At a median follow-up of 50.1 months, the 3- and 5-year bPFS was 97.3% and 95.2%, respectively. The 5-year bPFS rates for patients with and without I-PAI were 95.6% and 95%, respectively (p = 0.28). Conclusions: The use of CT-based PAI of ≤1 cm as a selection criterion for PB is a simple and reliable method for minimizing the incidence of I-PAI and maintaining excellent biochemical control rates.

Original languageEnglish (US)
Pages (from-to)249-254
Number of pages6
JournalRadiotherapy and Oncology
Volume91
Issue number2
DOIs
StatePublished - May 1 2009

Keywords

  • Brachytherapy
  • Dosimetry
  • Prostate cancer
  • Pubic arch interference
  • Radiotherapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Radiology Nuclear Medicine and imaging

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