MRI-guided prostate brachytherapy dose escalation to the dominant intraprostatic lesions: A retrospective analysis of urinary toxicity and biochemical response.
Bibliographic record
Abstract
47 Background: Magnetic resonance imaging (MRI) allows for delineation of the dominant intraprostatic lesions (DIL) thus minimizing the risk of a geographic miss. At our center, using MRI planning following the brachytherapy implant, the DIL is defined as the gross tumor volume (GTV) and receives at least the prescribed dose. This retrospective analysis studies the biochemical response and urinary symptoms of a MRI-guided escalated dose to the DIL during prostate brachytherapy. Methods: Intermediate- or high-risk patients with a visible DIL on the diagnostic MRI, treated between 2013 and 2016, with combined external-beam radiation therapy (46 Gray) and a high-dose rate whole prostate brachytherapy (15 Gray), were analyzed. Baseline characteristics and dosimetric values were obtained as well as PSA and International prostate symptom score (IPSS) at baseline, 3, 6, 12, 18, 24, 36 and 48 months (mos). Results: A total of 117 patients were studied, of which 58% were intermediate-risk and 42% high-risk. Median follow-up was 31 months (10-69 months). The biochemical progession-free survival (bPFS) was 97.4%. The median GTV D100 (dose to 100% of the GTV) and CTV V100 (percentage of the clinical target volume, defined as the whole prostate, receiving 100% of the prescribed dose) were 119% and 97.97%. The median PSA at 12, 24, 36 and 48 months for all patients and for patients treated without androgen deprivation therapy (ADT), was 0.18, 0.11, 0.06, 0.07 μg/L, and 0.73, 0.35, 0.1, 0.08 μg/L, respectively. The median IPSS score at baseline was 6 and remained stable over time. Conclusions: MRI-guided dose escalation to the GTV during brachytherapy boost yields an excellent bPFS and a rapid PSA drop without an increase in urinary symptoms. [Table: see text]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".