Intraoperative Neurovascular Bundle Preservation with Hyaluronic Acid during Radical Brachytherapy for Localized Prostate Cancer: Technique and MicroMosfet In Vivo Dosimetry

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Autores de IDIVAL

  • Pedro José Prada Gómez

    Autor

  • Maria Ferri Molina

    Autor

  • Juan Cardenal Carro

    Autor

  • Ana Soledad Garcia Blanco

    Autor

  • Elisabeth Estefania Arrojo Alvarez

    Autor

  • Javier Tomás Anchuelo Latorre

    Autor

  • Iván Díaz De Cerio Martínez

    Autor

  • Pedro Lastra García-Barón

    Autor

  • Alejandro Fernández Flórez

    Autor

  • Jose Andres Vazquez Rodriguez

    Autor

  • Samuel Ruiz Arrebola

    Autor

Unidades

Abstract

Purpose: To evaluate the reduction in the absorbed dose delivered to the neurovascular bundle (NB) in patients with localized prostate cancer treated with only HDR brachytherapy and NB protection with hyaluronic acid (HA) on the side of the prostate to increase the distance from NB to the radioactive sources. Methods: This is the first published report in the medical literature that studies a new approach to decrease neurovascular bundle toxicity and improve quality of life for patients with prostate cancer treated with radical brachytherapy as monotherapy. Transperineal HA injection on the side of the prostate into the lateral aspect of the prostate fat was used to consistently displace several autonomic fibers and vessels on the lateral wall of the prostate away from radiation sources. Results: When a protection in the form of an HA layer is placed, the reduction effect at the maximum dose is between 46% and 54% (calculated values), which means that the method for protection is highly recommended. The values of the absorbed dose calculated in this project have been compared with the ones given by the treatment planning system. Conclusions: This newly created space decreases absorbed dose in the NB, calculated with the TPS and measured by microMOSFET due to the thickness of HA.

Datos de la publicación

ISSN/ISSNe:
2227-9059, 2227-9059

Biomedicines  MDPI AG

Tipo:
Article
Páginas:
-
PubMed:
35625695

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Keywords

  • brachytherapy; neurovascular bundle; preservation; technique

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