296 Direct monitoring by Cook-Swartz Doppler – a study of 7 years in Free-Flaps operations; macro, micro and re-exploration results in regard to breast reconstructive surgeries

Abstract

Comparison of selected parameters of dose and volume treated with HDR-TD in three fractionation schemes, taking into account the biological dose.In the period from June 2006 to October 2007, study by the Department of Brachytherapy Cancer Centre in Poznan involved 65 male patients diagnosed with prostate cancer. Fifty-five patients were treated with radiotherapy: HDR-BRT + teleradiotherapy (EBRT), 37 received one and 18 two factions interstitial brachytherapy according to the scheme as follows: 50 Gy EBRT + / HDR-BRT 15 Gy (group I) and 46 Gy EBRT + / HDR-RTD 2 × 10 Gy (group II). Ten patients received monotherapy HDR-BRT as a method of self in three fractions and a total dose of 45 Gy (group III). We analyzed the dose and volume of the prostate, urethra and rectum. Dose value and volume were compared to assess the variability of different regimens.Dose value and volume in group II were statistically different from the other (SD-p, V120-p, Dmax-p, Dmean-u, Dmin-u, SD-u). Comparison of D90-p, V100-p, SD-p revealed less preferred percentages for the group of lower dose fractionation. P-V150, V120-p, were lower in the second chart. The statistical significance of differences between the values reported only V120-p (I – 70.5%, II – 67.6%, III – 68.7%). V200-p value exceeded the acceptance of the plan (15.9%) in the schema brachytherapy 2 × 10 Gy (p = 0.2795 in KW). In Dmax-p, the percentage was significantly higher and statistically significant change (I – 1066.5%, II – 1812.2%, III – 1078.2%, p = 0.0011 in KW). Parameters doses within the urethra showed clear increase in group II (D10-u, Dmin-u, Dmean-u, V100-u, SD-u) with increasing dose in the OAR. V100-u differs significantly (I – 46.1%, II – 54.2%, III – 49.3% – KW test, p = 0.036). Comparison of the Dmean-u (II – 97.7%, p = 0.0052), Dmin-u (II – 42.7%, p = 0.0027) just dropped. Dose percentages of the wall of the rectum were slightly higher in the 46 Gy / 2 × 10 Gy, but the application of Kruskal–Wallis test showed no statistical significance as compared to the parameters of volume and dose to the risk of the body.Dose and volume parameters differ in groups of fractional doses of 10 and 15 Gy (Kruskal–Wallis test). Demonstrated less favorable performance optimization in prostate volume, and higher doses of high-performance for the coil and rectum in group II (risk niedopromienienia at the lower dose in the high risk group). Higher doses within the coil and rectum may be irrelevant (the lower fractional dose used in group II).