MRI-Assisted Radiosurgery (MARS)
A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".
Deadline for manuscript submissions: closed (31 May 2024) | Viewed by 2434
Special Issue Editor
Special Issue Information
Dear Colleagues,
MRI-assisted radiosurgery (MARS) is a novel technology in prostate LDR brachytherapy (LDR-BT). As monotherapy for low- and intermediate-risk prostate cancer, LDR provides excellent oncologic results and favourable cost-effectiveness. However, a very accurate technology of imaging and planning is required to achieve high conformity and to preclude substantial side effects including urinary incontinence. The toxicity is related to doses in very fine structures—membranous urethra (MUL) and external urinary sphincter (EUS). Only MRI imaging is able to achieve a sufficient resolution of these structures' geometry and provide a sufficient basis for dose calculation, planning and delivery of permanent prostate seeds in the integral process of MARS. It has been employed since the previous decade and several encouraging results have been referred. Dose constraints for MUL and EUS have been introduced in relation to both acute and chronic urinary toxicity including incontinence and obstructive urinary symptoms. Compared to ultrasonography and CT-based planning, the lower constraints in MUL and EUS are achievable. Quality assurance measures for various sources I-125, Pd-103 and Cs-131 have been established. The objective urinary toxicity rate is lower for MARS and QOL outcomes are encouraging. Moreover, the cost-effectiveness analysis shows improved long-term costs of treatment. MARS as a technically more advanced and accurate method of brachytherapy desires prospective validation now.
Dr. Pavel Vítek
Guest Editor
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Keywords
- prostate cancer
- LDR brachytherapy
- MRI-based planning
- membranous urethra
- external urinary sphincter
- incontinence
- obstructive symptoms
- dose constraints
- quality of life
- cost-effectiveness