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Clinical Implementation of An In-House Made Perineal Template for Low Dose Rate Prostate Brachytherapy Treatment

J Urribarri*, Brigham & Woman's Hospital, South Weymouth, Massachusetts

Presentations

TU-F115-IePD-F6-6 (Tuesday, 7/12/2022) 1:15 PM - 1:45 PM [Eastern Time (GMT-4)]

Exhibit Hall | Forum 6

Purpose: An in-house perineal needle-template device was developed to improve the interactive1 low-dose-rate (LDR) brachytherapy treatment planning process for patients with small prostate volume size. One of the side effects of external beam radiation and androgen deprivation therapies is the significant reduction of the prostate gland volume (target) which can be challenging to plan with a standard 5mm hole spacing template.

Methods: Thirty patients with different prostate gland volumes size were selected for this study. These thirty patients received either external beam radiation alone or external radiation combined with androgen deprivation therapy. Patients had LDR interactive planning performed using the new template, BARD I-125 seed model STM1251 (USA, IL), BARD QuickLink Delivery System for the seed train assembly, Oncentra - Prostate (Elekta, Sweden) for the treatment planning software (TPS) and the B-K Medical Ultrasound 3000 (USA, MA) for the internal organs imaging.

Results: Thirty patients were successfully treated using the new template. The new template was modeled in TPS and the ultrasound system. The new template did not affect the calculating time in the TPS and the increased amount of hole locations provided more options for an easier manual optimization “tweaking” to achieve a final plan, especially in the apex location where the target tapers down in size.Initially, physician adaptation to the new template was challenging for the first few cases but rapidly improved as the physician became more familiar with the new hole patterns.

Conclusion: We have successfully designed, built and implemented a new template for brachytherapy LDR treatments of small sizes targets (≤20 cc). The new template has provided a viable option to implant the seeds inside or closer to the target periphery thus improving the interactive planning process significantly.

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