Clinical course and dosimetry of rectal fistulas after prostate brachytherapy

A. Howard, K. Wallner, B. Han, J. Dominitz, B. Schneider, S. Sutlief, J. Blasko, J. Downey, K. Billingsley

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Three patients with implant-related prostatic-rectal fistulas were identified among approximately 1000 previously treated prostate brachytherapy patients. Palladium-103 or iodine-125 implants were performed. Axial computed tomography (CT) images were acquired for postimplant dosimetry. Prostate contours were outlined on post-implant CT scans. The V100 was calculated as the percentage of the total prostate tissue or rectal volume (including the lumen) receiving 100% of the prescription dose or greater. The V200 was the total tissue receiving 200% of the prescription dose or greater. Dose parameters were compared with dosimetric parameters from a larger group of patients. The postimplant CTs and isodose calculations did not reveal significant source misplacement. Similarly, isodose displays showed little or no overlap of the prescription dose regions into the rectal wall. Calculation of rectal doses were similar to those of control patients without implant-related rectal bleeding and lower than those reported for patients with minor rectal morbidity. High-dose volumes (V100 and V200) within the prostate and rectum were similar to those of patients with little or no rectal morbidity. We conclude that serious rectal complications, a relative rarity, appear to occur in an unpredictable manner, typically unrelated to known dosimetric parameters.

Original languageEnglish (US)
Pages (from-to)37-42
Number of pages6
JournalJournal of Brachytherapy International
Issue number1
StatePublished - 2001
Externally publishedYes


  • Brachytherapy
  • Complications
  • Prostate Cancer
  • Rectum

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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