A dosimetric analysis of unstranded seeds versus customized stranded seeds in transperineal interstitial permanent prostate seed brachytherapy

Heysek, Randy V.; Gwede, Clement K.; Torres-Roca, Javier; Cantor, Alan; Kelley, Stacey; Saini, Amarjit S.; Pow-Sang, Julio

doi:10.1016/j.brachy.2006.08.003

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Volume 5, Issue 4 , Pages 244-250, October 2006

A dosimetric analysis of unstranded seeds versus customized stranded seeds in transperineal interstitial permanent prostate seed brachytherapy

Randy V. Heysek
- Radiation Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
- Central Florida Cancer Institute, Lake Wales, FL
- Corresponding author. Radiation Oncology Program, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, MOD-9-RT, Tampa, FL 33612. Tel.: +1-813-745-8424; fax: +1-813-745-7231.
Clement K. Gwede
- Radiation Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
- Central Florida Cancer Institute, Lake Wales, FL
- Health Outcomes and Behavioral Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
Javier Torres-Roca
- Radiation Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
Alan Cantor
- Biostatistical Core, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
Stacey Kelley
- Health Outcomes and Behavioral Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
Amarjit S. Saini
- Health Outcomes and Behavioral Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL
Julio Pow-Sang
- Genital Urinary Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL

Received 29 June 2006; received in revised form 31 July 2006; accepted 2 August 2006.

Abstract

Purpose

This study aimed to retrospectively analyze the dosimetric and toxicity results from 272 patients with localized prostate cancer treated consecutively using loose or stranded radioactive seeds by transrectal ultrasound-guided transperineal permanent prostate seed brachytherapy.

Methods and materials

Two hundred seventy-two patients with localized prostate cancer treated between February 2002 and June 2004 were analyzed. All patients were treated with radioactive iodine-125 or palladium-103 using unstranded or loose seeds (USS) (159 patients) or customized stranded seeds (CSS) at variable spacing (5–50mm) (113 patients) (Vari-Strand™; BrachySciences, Oxford, CT). A single experienced brachytherapist performed all implants.

Results

There was a slight improvement in the dosimetric parameter D₉₀ between the CSS (101.9%) and USS (99.3%) groups (p=0.041). However, overall implant quality based on Radiation Therapy Oncology Group (RTOG) guidelines was similar between both groups.

Conclusions

We conclude that the D₉₀ value calculated for CSS is statistically improved when compared to the USS cohort, but without a clinically significant difference. There was no difference in the toxicity scores in either group. Overall quality between groups is comparable in our institution.

Keywords: Prostate cancer, Brachytherapy, Dosimetry