Radiogene Nephropathie

2010 ◽  
Vol 49 (S 01) ◽  
pp. S59-S63 ◽  
Author(s):  
M. Gotthardt
Keyword(s):  
Side Effects ◽  
External Beam Radiotherapy ◽  
Antibody Fragments ◽  
External Beam ◽  
Internal Radiotherapy ◽  
Organ Volume ◽  
Recent Developments ◽  
Individual Dosimetry ◽  
Complex Models ◽  
Radiobiological Effects

SummaryPatient-individual dosimetric analyses are a useful tool in external beam radiotherapy (EBR) to protect patients from side effects such as radiogenic nephropathy. At this point in time, individual dosimetry is not used as a standard in patient treated with radiolabelled antibody fragments or polypeptides. The reasons are a number of problems, which make patient dosimetry more challenging than in EBR. While in EBR, the dose is distributed evenly in the organ and the organ volume can exactly be determined, in internal radiotherapy the tracer is not evenly distributed within the organ leading to a non-uniform dose distribution. In addition, the dose rate of the most commonly used radionuclides is lower than in EBR and the range of their radiation differ, so that the radiobiological effects are differing considerably in comparison to EBR. Conclusion: More complex models have to be used for clinical kidney dosimetry in internal radiotherapy.In this paper, we give a concise overview of the reasons for accumulation of radiotracers in the kidney, the most recent developments in kidney dosimetry, and approaches to reduce the kidney uptake of radiotracers in order to avoid radiogenic nephropathy.

Artificial intelligence in brachytherapy: a summary of recent developments

2021 ◽  
pp. 20200842
Author(s):  
Susovan Banerjee ◽  
Shikha Goyal ◽  
Saumyaranjan Mishra ◽  
Deepak Gupta ◽  
Shyam Singh Bisht ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
External Beam ◽  
Human Errors ◽  
Ample Evidence ◽  
Recent Developments ◽  
Human Effort ◽  
Almost All ◽  
Direct Use

Artificial intelligence (AI) applications, in the form of machine learning and deep learning, are being incorporated into practice in various aspects of medicine, including radiation oncology. Ample evidence from recent publications explores its utility and future use in external beam radiotherapy. However, the discussion on its role in brachytherapy is sparse. This article summarizes available current literature and discusses potential uses of AI in brachytherapy, including future directions. AI has been applied for brachytherapy procedures during almost all steps, starting from decision-making till treatment completion. AI use has led to improvement in efficiency and accuracy by reducing the human errors and saving time in certain aspects. Apart from direct use in brachytherapy, AI also contributes to contemporary advancements in radiology and associated sciences that can affect brachytherapy decisions and treatment. There is a renewal of interest in brachytherapy as a technique in recent years, contributed largely by the understanding that contemporary advances such as intensity modulated radiotherapy and stereotactic external beam radiotherapy cannot match the geometric gains and conformality of brachytherapy, and the integrated efforts of international brachytherapy societies to promote brachytherapy training and awareness. Use of AI technologies may consolidate it further by reducing human effort and time. Prospective validation over larger studies and incorporation of AI technologies for a larger patient population would help improve the efficiency and acceptance of brachytherapy. The enthusiasm favoring AI needs to be balanced against the short duration and quantum of experience with AI in limited patient subsets, need for constant learning and re-learning to train the AI algorithms, and the inevitability of humans having to take responsibility for the correctness and safety of treatments.

scholarly journals Technologies for delivery of proton and ion beams for radiotherapy

2014 ◽  
Vol 29 (14) ◽  
pp. 1441002 ◽  
Author(s):  
Hywel Owen ◽  
David Holder ◽  
Jose Alonso ◽  
Ranald Mackay
Keyword(s):  
Historical Development ◽  
Recent Progress ◽  
Ion Beam ◽  
External Beam Radiotherapy ◽  
Cost Effective ◽  
Ion Beams ◽  
Particle Accelerators ◽  
External Beam ◽  
Ion Beam Therapy ◽  
Recent Developments

Recent developments for the delivery of proton and ion beam therapy have been significant, and a number of technological solutions now exist for the creation and utilisation of these particles for the treatment of cancer. In this paper we review the historical development of particle accelerators used for external beam radiotherapy and discuss the more recent progress towards more capable and cost-effective sources of particles.

scholarly journals Comparison of EBRT and I-125 seed brachytherapy concerning outcome in intermediate-risk prostate cancer

2021 ◽  
Author(s):  
Matthias Moll ◽  
Andreas Renner ◽  
Christian Kirisits ◽  
Christopher Paschen ◽  
Alexandru Zaharie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Cancer Patients ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Intermediate Risk ◽  
Risk Prostate Cancer ◽  
Gastrointestinal Side Effects ◽  
Over Time

Abstract Purpose This study’s objective was the comparison of external beam radiotherapy (EBRT) and I‑125 seed brachytherapy regarding clinical outcome and development of side effects. Patients and methods In all, 462 localized intermediate-risk prostate cancer patients treated between 2000 and 2019 at our department using either I‑125 seed brachytherapy or EBRT with a dose of 74 or 78 Gy were included: 297 patients were treated with EBRT and 165 with seeds. Biochemical no evidence of disease (bNED) rates according to Phoenix definition as well as late gastrointestinal and urogenital side effects (EORTC/RTOG) were assessed. Results Patients were followed up yearly with a median follow-up of 54 (3–192) months. Observed bNED rates for 74 Gy, 78 Gy and seeds were 87, 92, and 88% after 5 years and 71, 85, and 76% after 9 years, respectively. No significant differences were found comparing seeds with 74 Gy (p = 0.81) and 78 Gy (p = 0.19), as well as between 74 and 78 Gy (p = 0.32). Concerning gastrointestinal side effects, EBRT showed significantly higher rates of RTOG grade ≥ 2 toxicity compared to seeds, but at no point of the follow-up more than 10% of all patients. However, genitourinary side effects were significantly more prevalent in patients treated with seeds, with 33% RTOG grade ≥ 2 toxicity 12 months after treatment. Nevertheless, both types of side effects decreased over time. Conclusion Favorable intermediate-risk prostate cancer patients can be treated either by external beam radiotherapy (74/78 Gy) or permanent interstitial seed brachytherapy.

scholarly journals Combination therapy-permanent interstitial brachytherapy and external beam radiotherapy for patients with localized prostate cancer

2005 ◽  
Vol 52 (4) ◽  
pp. 31-36 ◽  
Author(s):  
H. Matzkin ◽  
G. Keren-Paz ◽  
N.J. Mabjeesh ◽  
J. Chen
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Combination Therapy ◽  
External Beam Radiotherapy ◽  
Localized Prostate Cancer ◽  
Interstitial Brachytherapy ◽  
External Beam Radiation ◽  
Treatment Modalities ◽  
External Beam ◽  
Beam Radiation

Background: Combination of permanent interstitial brachytherapy based on radioactive iodine with external beam radiotherapy is an alternative to other treatment modalities, such as radical prostatectomy or external beam radiotherapy alone in patients with intermediate-risk localized prostate cancer. In this article we report our experience with this combination modality. Methods: Among patients who were treated in our institute with brachytherapy, there were 64 patients who received combination therapy for the above indication. Combination therapy enables administration of 110 Gy as brachytherapy and thereafter 45 Gy as external beam radiation. All patients received adjuvant androgen deprivation therapy for 6 months. The prospective follow-up was done with the aid of validated evaluation instruments (questionnaires). Results: Combination therapy was administered without additional urinary (IPSS-based) or sexual (IIEFbased) side effects above those with brachytherapy alone. No severe perianal and lower intestinal tract side effects were observed. Short-to-moderate-term results based on serum PSA levels are encouraging, and are not inferior to what is accepted by the literature for other radical therapies. Conclusion: Combination of permanent interstitial brachytherapy and external beam radiotherapy in the appropriate patients does not cause any additional morbidity, and its biochemical results justify its application. This modality should be offered as an accepted and good alternative to other radical treatment options, to men with prostate cancer with moderate risk factors.

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