19-20 MAY 2017

Prostate Cancer Brachytherapy

May 19, 2017

May 20, 2017

07:40 - 07:49

Welcome

Moderator : Marjory Jolicoeur, MD

Welcome
07:49 - 10:18

Session I

Session I: Diagnosis and Imaging

Moderator : Cynthia Ménard, MD

Discuss imaging in prostate cancer

Discuss the use of imaging for accurate diagnosis

Evaluate event

Show Objectives
07:50 - 08:00

Session I

Prostate anatomy

Speaker: Hugo Villeneuve, MD

Identify the organs surrounding the prostate

Describe the prostate's innervation

Describe the prostate's zonal anatomy

Relate prostate anatomy to the biopsy map

Evaluate

Show Objectives
08:00 - 08:50

Session I

Male pelvis and imaging: US, CT-scan, and multiparametric MRI

Speaker: Vincent Pelsser, MD

Review male pelvic anatomy on 3D imaging

Recognize the OARs on imaging

Recognize the prostate's limits in relation with the OAR and identify it on each modality.

Review the prostate's lymphatic drainage

Know the specificities of each imaging modality

Identify the prostate on MRI

Choose the right MRI sequence for tumor identification

Use the information on upstaging wisely

Evaluate

Show Objectives
08:50 - 09:20

Session I

Can we still rely on random TRUS biopsy?

Speaker: Frank Bladou, MD

Explain the rationale behind false negative biospies with random prostate biopsies, and their incidence

Identify the incidence of anterior lesions

Explain their impact on treatment

Explain prostate fusion guided biopsies and their results

Evaluate

Show Objectives
09:20 - 09:45

Session I

Finding the aggressive disease in prostate cancer: multi parametric MRI and gene expression profiles

Speaker: Alan Pollack, MD

Explain prostate cancer heterogeneity and multifocality

Determine the association between findings on imaging and poor prognostic genes in prostate cancer

Explain the clinical implications of such associations

Evaluate

Show Objectives
09:45 - 09:55

Session I

Quiz: prostate anatomy

Anatomy quiz

Show Objectives
09:50 - 10:20

Coffee Break

Exhibitors

Poster viewing
10:19 - 14:10

Session II

Session II: Dose escalation

Moderator : Alan Pollack, MD

Explain the reasons for dose escalation, the methods to achieve it and its toxicities.

Show Objectives
10:20 - 11:00

Session II

Dose escalation for prostate cancer

Speaker: Tamim Niazi, MD

Explain recurrence rates after EBRT

Explain the different dose escalation techniques, including brachytherapy, hypofractionation and SBRT

Evaluate

Show Objectives
11:00 - 11:10

Session II

Patient selection for LDR brachytherapy

Speaker: Eric Vigneault, MD

Review LDR brachytherapy's history in the treatment of prostate cancer

Master the steps for adequate patient selection

Discuss the indications and contra-indications for LDR brachytherapy

Show Objectives
11:10 - 11:30

Session II

LDR boost: patient selection and literature review

Speaker: Eric Vigneault, MD

Explain the results of this treatment

Evaluate

Show Objectives
11:30 - 13:00

Lunch

Lunch break
13:00 - 13:20

Session II

HDR boost: patient selection and literature review

Speaker: Peter Hoskin, MD

Review HDR brachytherapy history in the treatment of prostate cancer

Master the steps for adequate patient selection

Understand the indications and contra-indications for HDR brachythrapy

Explain the results of this treatment

Evaluate

Show Objectives
13:19 - 14:10

Session III

Session III: Androgen Deprivation Therapy

Moderator : Thu Van Nguyen, MD

Discuss androgen deprivation therapy combined with brachytherapy
13:20 - 13:50

Session III

Androgen deprivation therapy combined with prostate brachytherapy: when, why, and how?

Speaker: Carl Salembier, MD

Review the literature supporting androgen deprivation thrapy in combination with brachytherapy

Explain its use in prostate volume reduction

Discuss the toxicities of this treatment

Evaluate

Show Objectives
13:50 - 14:10

Session III

Combining brachytherapy with androgen deprivation therapy: ASCENDE-RT trial

Speaker: James Morris, MD

Explain the reasons behind this management

Discuss the use and duration of androgen deprivation in combination with EBRT and brachytherapy

Discuss the toxicities of this treatment

Evaluate

Show Objectives
14:09 - 15:15

Session IV

Session IV: Patient preparation and QOL

Moderator : Thu Van Nguyen, MD

Discuss patient preparation before brachytherapy

Discuss QOL after brachytherapy

Show Objectives
14:10 - 14:25

Session IV

Antibiotic prophylaxis and prostate brachytherapy

Speaker: Talar Derashodian, MD

Discuss the literature supporting this management

Explain the management in Quebec's radiation oncology centers

Evaluate

Show Objectives
14:25 - 14:40

Session IV

PSA bounce detection: timing and management

Speaker: André-Guy Martin, MD

Explain the mechanism of PSA bounce

Explain its timing, its incidence and its management

Discuss the psychological fallouts of a PSA bouce

Evaluate

Show Objectives
14:40 - 15:00

Session IV

Erectile function and prostate brachytherapy

Speaker: Serge Carrier, MD

Explain the mechanism of erectile dysfunction

Discuss the incidence of erectile dysfunction after brachytherapy

Discuss prevention and treatment

Evaluate

Show Objectives
15:00 - 15:15

Session IV

Toxicity of prostate brachytherapy

Speaker: Marie Duclos, MD

Discuss LDR and HDR brachytherapy toxicities

Explain the timing of each toxicity

Discuss prevention and treatment

Evaluate

Show Objectives
15:15 - 15:45

Coffee break

Exhibitors

Poster viewing
15:44 - 18:00

Session V

Session V: Planning

Moderator : Maryse Mondat, Physicienne médical

Discuss brachytherapy planning
15:45 - 16:00

Session V

Physics: LDR system commissioning, dosimetry and quality assurance

Speaker: Joanna Cygler, Physicienne médical

Explain the physics workflow for LDR brachytherapy

Master the steps to obtain the dosimetry

Review the commissioning and quality assurance of a LDR system

Evaluate

Show Objectives
16:00 - 16:15

Session V

Intra-operative planning for LDR and HDR brachytherapy

Speaker: Joanna Cygler, Physicienne médical

Explain the intra-operative planning techique

Discuss the advantages and disadvantages of these techniques

Evaluate

Show Objectives
16:00 - 18:00

Session V

Hands-on workshop: contouring, planning, and implantation

Speakers: Talar Derashodian, MD & Marjory Jolicoeur, MD & Maryse Mondat, Physicienne médical & Peter Hoskin, MD & Alvaro Martinez, MD & Carl Salembier, MD

Contours

Delineate GTV, CTV, and PTV

Discuss and correct contours

Carl Salembier, Talar Derashodian

Evaluate

Planning

Achieve implant reconstruction and dosimetry

Explain possible pitfalls at each step

Peter Hoskin, Maryse Mondat

Evaluate planning

Implant technique

Discuss the use of imaging modalities

Master the steps to a good implant

Alvaro Martinez, Marjory Jolicoeur

Evaluate implant technique

There will be 3 groups. Each workshop will last 45 minutes and groups will rotate

Show Objectives

07:00 - 07:30

Registration and breakfast

Registration
07:29 - 11:00

Session VI

Session VI: HDR brachytherapy for prostate cancer

Moderator : Alvaro Martinez, MD

Discuss HDR brachytherapy in prostate cancer
07:30 - 07:50

Session VI

Physics: HDR system commissioning, dosimetry and quality assurance

Speaker: Aimée Lauzon, Physicienne médical

Explain the physics workflow for HDR brachytherapy

Master the steps to obtain the dosimetry

Discuss the difficulties pertaining to MRI use for dosimetry

Review the commissioning and quality assurance of a HDR system

Evaluate

Show Objectives
07:50 - 08:10

Session VI

What is the precision of image registration?

Speaker: Samuel Kadoury, Engineer

Explain the goal of image registration

Compare rigid vs deformable registration: pros vs cons

Discuss the pitfalls of image registration

Dicuss the future of image registration

Evaluate

Show Objectives
08:10 - 08:20

MRI-US fusion and its use in brachytherapy

Speaker: Cynthia Ménard, MD

Clinical use of MRI fusion for brachytherapy contouring

Understand the pros and cons of this technique in the clinical setting

Evaluate

Show Objectives
08:20 - 09:00

Session VI

HDR brachytherapy: implant technique and dose discussion

Speakers: Marjory Jolicoeur, MD & André-Guy Martin, MD & Peter Hoskin, MD & Alvaro Martinez, MD & Cynthia Ménard, MD & Carl Salembier, MD

Compare different techniques of HDR brachytherapy in prostate cancer

Present videos showing all the steps for a successful implant

Evaluate

Show Objectives
09:00 - 09:20

Session VI

Clinical results of combination HDR brachytherapy with external beam radiotherapy

Speaker: André-Guy Martin, MD

Discuss the clinical results of this treatment

Discuss the toxicities of this treatment

Evaluate

Show Objectives
09:20 - 09:35

Session VI

HDR brachytherapy for prostate cancer: MRI experience at CHUM

Speaker: Cynthia Ménard, MD

Discuss CHUM's experience with prostate brachytherapy and MRI

Evaluate

Show Objectives
09:35 - 09:50

Session VI

Prostate HDR brachytherapy: Charles Lemoyne's experience with MRI

Speakers: Talar Derashodian, MD & Marjory Jolicoeur, MD

Discuss Charles LeMoyne's experience and results in prostate HDR brachytherapy

Evaluate

Show Objectives
09:50 - 10:20

Session VI

Coffee break

Exhibitors

Poster viewing session
10:20 - 10:30

Session VI

Combination EBRT and brachytherapy in high risk patients: BRP-1 results

Speaker: Marjory Jolicoeur, MD

Discuss the results and toxicities of treatment in BRP-1 phase II trial

Evaluate

Show Objectives
10:30 - 11:00

Session VI

Prostate HDR brachytherapy: discussion

Discuss issues in HDR brachytherapy for prostate cancer
10:59 - 13:40

Session VII

Session VII: Focal and Salvage brachytherapy

Moderator : Peter Hoskin, MD

Discuss the use of focal and salvage brachytherapy
11:00 - 11:20

Session VII

Salvage brachytherapy for local recurrence after EBRT

Speaker: Alvaro Martinez, MD

Explain the indications for salvage brachytherapy

Evaluation of the patient before salvage brachytherapy

Explain the particularities of salvage brachytherapy

Explain the results and toxicities of this treatment.

Evaluate

Show Objectives
11:20 - 11:40

Session VII

Focal brachytherapy for prostate cancer

Speaker: André-Guy Martin, MD

Explain the indications and the results of this treatment.

Discuss the pitfalls of this management.

Discuss the toxicities of the treatment

Discuss Hotel Dieu de Quebec's experience.

Evaluate

Show Objectives
11:40 - 13:00

Lunch

Lunch break
13:00 - 13:30

Session VII

How to address the dominant intraprostatic lesion in prostate radiation therapy treatments

Speaker: Alan Pollack, MD

Review the concept of DIL, and the means to identify it

Explain DIL treatment modilities, including brachytherapy

Explain the dosimetric constraints when treating the DIL

Identify the benefits of dose escalation on the DIL

Evaluer

Show Objectives
13:29 - 14:50

Session VIII

Session VIII: HDR brachytherapy monotherapy

Moderator : Marjory Jolicoeur, MD

Discuss the use of HDR brachytherapy monotherapy in the treatment of prostate cancer

Show Objectives
13:30 - 13:50

Session VIII

HDR monotherapy: Michigan"s experience

Speaker: Alvaro Martinez, MD

Discuss Michigan's experience in monotherapy for prostate cancer

Discuss their results and toxicities

Evaluate

Show Objectives
13:50 - 14:10

Session VIII

HDR monotherapy: UK's experience

Speaker: Peter Hoskin, MD

Discuss UK's experience in monotherapy for prostate cancer

Explain dose escalation results with monotherapy

Discuss their results and toxicities

Evaluate

Show Objectives
14:10 - 14:30

Session VIII

HDR monotherapy indications: literature review

Speaker: Hugo Villeneuve, MD

Review the available literature

Master the steps for adequate patient selection

Understand the indications and contra-indications for HDR monotherapy

Explain the results of this treatment

Evaluate

Show Objectives
14:30 - 14:50

Session VIII

HDR monotherapy toxicities

Speaker: Peter Hoskin, MD

Explain the toxicities, their timing and their incidence.

Explain prevention measures and possible treatments.

Evaluate

Show Objectives
14:49 - 16:00

Session IX

Session IX: Debates

Moderators : Marjory Jolicoeur, MD & Eric Vigneault, MD

Debate the pros and cons of LDR vs HDR brachytherapy and monotherapy vs combination therapy

Show Objectives
14:50 - 15:00

Session IX

LDR vs HDR brachytherapy for combination treatment

Speakers: André-Guy Martin, MD & Carl Salembier, MD

Debate the pros and cons for each treatment

Pro LDR: Carl Salembier

Pro HDR: André-Guy Martin

Referee: Eric Vigneault

Show Objectives
15:00 - 15:10

Session IX

HDR monotherapy vs combination therapy in intermediate risk prostate cancer

Speakers: James Morris, MD & Peter Hoskin, MD

Discuss the pros and cons for each treatment

Pro Monotherapy: James Morris

Pro Combination therapy: Peter Hoskin

Referee: Marjory Jolicoeur

Show Objectives
15:10 - 16:00

Session IX

Discussion: questions and answers

Discussion period
15:50 - 16:30

Closing Ceremony

Closing ceremony

Prostate Cancer Brachytherapy

07:40 - 07:49

Welcome

07:49 - 10:18

Session I

Session I: Diagnosis and Imaging

07:50 - 08:00

Session I

Prostate anatomy

08:00 - 08:50

Session I

Male pelvis and imaging: US, CT-scan, and multiparametric MRI

08:50 - 09:20

Session I

Can we still rely on random TRUS biopsy?

09:20 - 09:45

Session I

Finding the aggressive disease in prostate cancer: multi parametric MRI and gene expression profiles

09:45 - 09:55

Session I

Quiz: prostate anatomy

09:50 - 10:20

Coffee Break

10:19 - 14:10

Session II

Session II: Dose escalation

10:20 - 11:00

Session II

Dose escalation for prostate cancer

11:00 - 11:10

Session II

Patient selection for LDR brachytherapy

11:10 - 11:30

Session II

LDR boost: patient selection and literature review

11:30 - 13:00

Lunch

13:00 - 13:20

Session II

HDR boost: patient selection and literature review

13:19 - 14:10

Session III

Session III: Androgen Deprivation Therapy

13:20 - 13:50

Session III

Androgen deprivation therapy combined with prostate brachytherapy: when, why, and how?

13:50 - 14:10

Session III

Combining brachytherapy with androgen deprivation therapy: ASCENDE-RT trial

14:09 - 15:15

Session IV

Session IV: Patient preparation and QOL

14:10 - 14:25

Session IV

Antibiotic prophylaxis and prostate brachytherapy

14:25 - 14:40

Session IV

PSA bounce detection: timing and management

14:40 - 15:00

Session IV

Erectile function and prostate brachytherapy

15:00 - 15:15

Session IV

Toxicity of prostate brachytherapy

15:15 - 15:45

Coffee break

15:44 - 18:00

Session V

Session V: Planning

15:45 - 16:00

Session V

Physics: LDR system commissioning, dosimetry and quality assurance

16:00 - 16:15

Session V

Intra-operative planning for LDR and HDR brachytherapy

16:00 - 18:00

Session V

Hands-on workshop: contouring, planning, and implantation

07:00 - 07:30

Registration and breakfast