Pilot Study Testing the Technical Feasibility and Toxicity of High Dose Rate Brachytherapy Combined with Hyperthermia to Treat Prostate Cancer Recurrences after External Beam Irradiation or Permanent Seed Implant Failure

摘要

The principal objective of this research is the development of the combination of hyperthermia (HT) and high dose rate (HDR) brachytherapy as a therapy for locally advanced, recurrent prostate cancer after failure using front line external beam definitive radiation therapy (EBRT). We had previously developed a system for low dose rate systems (LDR), however technological advances in HDR systems make the application of LDR essentially obsolete. There are several fundamentally different aspects to HDR practice and dosimetry, which render the LDR technology developed here obsolete as well. As a result the first three tasks in the statement of work are the development of a new template system, new software to control power deposition in the tumor and phantom testing before beginning patient treatment. As is demonstrated in the body of this report all three tasks have been completed on schedule. The new HDR template design differs radically from the older LDR system is easier to set up and more comfortable for the patient. The software was completely re- written to accommodate the fundamentally different HDR dosimetric approach. The combination of the hardware and software was then extensively tested on phantoms. Once satisfied that the system was safe for human application one patient was treated in accordance with the approved protocol during year 1. The final task is the development of heat activated gene therapy as an adjuvant to HDR brachytherapy specifically applied to this proposal but which should have considerably broader applicability in cancer treatment.