Prostate implant evaluation using tumour control probability--the effect of input parameters

Phys Med Biol. 2004 Aug 21;49(16):3649-64. doi: 10.1088/0031-9155/49/16/012.

Abstract

In this paper, we examine the effect of treatment parameters in a model used to evaluate permanent prostate implants. The model considers the prostate to be composed of 12 sub-sections, each sub-section is assigned a cell density based on the probability of finding cancer foci in that sub-section. Wasted dose as a result of the dose rate from the implant falling below a level adequate to counteract repopulation was found to vary by 2-16% over the range of radiosensitivity and repopulation rates considered. Within the model, applied to five dose distributions, the uncertainty in the tumour control probability (TCP) values calculated for each sub-section as a result of differences in the model parameters, was found to be less than 12% in most cases for the good quality implants. The difference in TCP values was much larger for the poor quality implant. Substituting a heterogeneous distribution of alpha for a single mean value resulted in generally lower TCP values though introducing a cutoff value with a Gaussian distribution had a profound effect on the calculated values. Despite uncertainties in the parameters, the model was able to identify sub-sections at risk of local recurrence but as a result of these uncertainties, the TCP values can only be considered in the relative rather than absolute sense.

MeSH terms

  • Brachytherapy / methods*
  • Dose-Response Relationship, Radiation
  • Humans
  • Male
  • Models, Statistical
  • Models, Theoretical
  • Normal Distribution
  • Probability
  • Prostate / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Sensitivity and Specificity
  • Time Factors