RESUMEN
AIM: Biochemical relapse-free survival (bRFS) rate is determined by a cohort of Mexican patients (n = 595) with prostate cancer who received treatment with external radiotherapy. BACKGROUND: Patients with prostate cancer were collected from CMN Siglo XXI (IMSS), CMN 20 de Noviembre (ISSSTE), and Hospital General de México (HGM). For the IMSS, 173 patients that are treated with three-dimensional conformal radiation therapy (3D-CRT) and 250 with SBRT, for the ISSSTE 57 patients are treated with 3D-CRT and on the HGM 115 patients are managed with intensity modulated radiation therapy (IMRT). The percentage of patients by risk group is: low 11.1%, intermediate 35.1% and high 53.8%. The average follow-up is 39 months, and the Phoenix criterion was used to determine the bRFS. MATERIALS AND METHODS: The Kaplan-Meier technique for the construction of the survival curves and, the Cox proportional hazards to model the cofactors. RESULTS: (a) The bRFS rates obtained are 95.9% for the SBRT (7 Gy fx, IMSS), 94.6% for the 3D-CRT (1.8 Gy fx, IMSS), 91.3% to the 3D-CRT (2.65 Gy fx, IMSS), 89.1% for the SBRT (7.25 Gy fx, IMSS), 88.7% for the IMRT (1.8 Gy fx, HGM) %, and 87.7% for the 3D-CRT (1.8 Gy fx, ISSSTE). (b) There is no statistically significant difference in the bRFS rates by fractionation scheme, c) Although the numerical difference in the bRFS rate per risk group is 95.5%, 93.8% and 89.1% for low, intermediate and high risk, respectively, these are not statistically significant. CONCLUSIONS: The RT techniques for the treatment of PCa are statistically equivalent with respect to the bRFS rate. This paper confirms that the bRFS rates of Mexican PCa patients who were treated with conventional vs. hypofractionated schemes do not differ significantly.
RESUMEN
The quality and correctness of dosimetric data of small fields in stereotactic radiosurgery (SRS) depends significantly on the election of the detector employed in the measurements. This work provides an independent method of verification of these data through the determination of a polyenergetic 2-dimensional pencil-beam kernel for a BrainLAB SRS system with cones, employing the deconvolution/convolution of a reference experimental off-axis ratio (OAR) profile (cone diameter c0 = 35 mm). The kernel in real space k(c(0))(r,z(0)) is convolved with the ideal fluence Φ for the cones 7.5 to 35 mm in diameter to obtain the OAR profiles, and the total scatter factors, St, which are compared with experimental values of the same quantities. The experimental OARs and St factors are measured in water with a PTW 60003 diamond detector. Additionally, the reference OAR is corrected for beam divergence and spectral fluence fluctuations defining a function of boundary correction factors (BF). The BF and Φ functions are transformed to the conjugate space with the zeroth-order Hankel transform, appropriated to the radial symmetry of the cones. Therefore, the kernel in real space k(c(0))(r,z(0)) is the inverse Hankel transform of the ratio of the Hankel transforms of BF and Φ. Finally, an uncertainty analysis according to the Guide to the Expression of Uncertainty in Measurement is carried out for 3 different values of k(c(0))(r,z(0)). Calculated and measured OARs agree within the dose/distance-to-agreement criteria of 2%/0.12 mm; while, St factors agree within 2%. This procedure supplies an independent method to validate the dosimetric data necessary to feed treatment planning systems for SRS with cones.