Abstract | INTRODUCTION:
Radiation therapy (RT) after radical prostatectomy (RP) has been associated with a survival benefit in both the adjuvant and salvage setting. Nevertheless, optimal targeting of the prostate bed following surgery remains challenging. The Calypso 4D Localization System ( Calypso Medical Technologies, Seattle, WA, USA) is a target positioning device that continuously monitors the location of three implantable electromagnetic transponders. We describe our technique of ultrasound-guided placement of these transponders into the prostate bed for adjuvant and salvage RT. METHODS: Seventeen patients presenting to Fox Chase Cancer Center for postoperative RT underwent transrectal ultrasound-guided placement of Calypso beacons. The three transponders were placed approximately 1 cm apart in a triangular fashion around the vesico-urethral anastomosis and in the retrovesicular tissue. RESULTS: All patients were successfully implanted without periprocedural complications. Appropriate beacon position was confirmed by CT scan performed at the time of RT simulation. Intensity-modulated radiation therapy was delivered at a dose of 68 Gy (range 64-68). Treatment was well-tolerated with no Grade 3 or 4 toxicities. Grade > 2 enteritis was not observed, and there were no cases of rectal bleeding. Genitourinary toxicity was noted in 10 patients and consisted of Grade 1 and 2 frequency and dysuria. No patient developed gross hematuria or urinary retention. All patients (9/9) with at least 6 months of follow up after treatment had an undetectable PSA. CONCLUSIONS: The placement of Calypso transponders for adjuvant/salvage RT is a safe and efficacious method for treatment targeting with an acceptable acute toxicity profile.
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Authors | Daniel Canter, Richard E Greenberg, Eric M Horwitz, Alexander Kutikov, Jinsheng Li, Christopher Long, Mark Buyyounouski, Stephen A Boorjian |
Journal | The Canadian journal of urology
(Can J Urol)
Vol. 17
Issue 5
Pg. 5365-9
(Oct 2010)
ISSN: 1195-9479 [Print] Canada |
PMID | 20974028
(Publication Type: Journal Article)
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Topics |
- Aged
- Fiducial Markers
(adverse effects)
- Humans
- Male
- Middle Aged
- Prostatectomy
- Prostatic Neoplasms
(radiotherapy, surgery)
- Radio Waves
- Radiotherapy, Adjuvant
(instrumentation, methods)
- Radiotherapy, Intensity-Modulated
(instrumentation, methods)
- Salvage Therapy
(instrumentation, methods)
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