S168
Brachytherapy - Urology
ESTRO 2026
References: Chung E, et al. Brachytherapy simulation in prostate cancer education: a systematic review. Brachytherapy. 2020;19(3):227–235.Kneebone R. Simulation in clinical education: a brief history and review of current practice. Med Educ. 2016;50(11):1086–1092.Tocco- Tussardi I, et al. Simulation-based learning in radiation oncology: current status and future perspectives. Radiother Oncol. 2023;183:109587. Digital Poster 2899 Comparing the efficacy of prostate SABR to low dose rate focussed boost brachytherapy treatment. Christof Kastner 1 , Diane Whitney 2 , David O'Doherty 2 , Simon G Russell 3 , Deborah L Gregory 3 , Henno Martin 3 , Lily Austin 4 1 UROLOGY, CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST, Cambridge, United Kingdom. 2 MEDICAL PHYSICS, CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST, Cambridge, United Kingdom. 3 ONCOLOGY, CAMBRIDGE UNIVERSITY HOSPITALS NHS FOUNDATION TRUST, Cambridge, United Kingdom. 4 UROLOGY, NORTH WEST ANGLIA NHS FOUNDATION TRUST, Peterborough, United Kingdom Purpose/Objective: Prior to PACE-B and the introduction of prostate SABR, external beam radiotherapy (EBRT) for low and intermediate risk prostate cancer required patients to attend between 20 and 39 treatment appointments. This gave a significant advantage with respect to convenience, to the option of single procedure Low Dose Rate (LDR) brachytherapy.The advent of five fraction SABR has provided a treatment option that offers a patient convenience advantage similar to that of LDR brachytherapy.The aim was to compare SABR and LDR brachytherapy dose and side effect profile evidence to demonstrate that focussed boost LDR brachytherapy is an excellent treatment option for this cohort of patients with respect to efficacy as well as convenience. Material/Methods: AI contouring and fusion of diagnostic MRI to theatre US were used to identify and focus boost the histology confirmed Gross Target Volume (GTV) as part of standard whole prostate brachytherapy.Biological effective Dose (BED) for GTV and whole prostate and side effect data (IPSS and IEFF toxicity scores) for focussed boost LDR were analysed and compared to PACE B standard EBRT and SABR values. Results: Focussed Boost LDR doses of >160% of prescription dose to GTV means LDR brachytherapy delivers the
highest dose to GTV compared to any current EBRT schedule available to this cohort of patients, including
PACE SBRT.
Acute and intermediate side effects are comparable for focussed boost LDR brachytherapy, standard EBRT and SABR PACE B data.
Conclusion: Using diagnostic MR and biopsy histology to accurately identify and boost GTV as best practise in LDR brachytherapy, results in a dose equivalent to and greater than SBRT, with comparable side effect profile.Focussed boost LDR brachytherapy provides a treatment option that competes with five fraction prostate SABR with respect to dose and toxicity for this cohort of patients Keywords: LDR, Focussed Boost, PACE References: Douglas H Brand, Alison C Tree, Peter Ostler, Hans van der Voet, Andrew Loblaw, William Chu, et al 2019 “Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial” The Lancet Oncology November Volume 20, Issue 11 p1531-1543.Alison C Tree, Peter Ostler, Hans van der
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