New implant technique for separation of the seminal vesicle and rectal mucosa for high-dose-rate prostate brachytherapy

Yoshida, Ken; Kuroda, Satoru; Yoshida, Mineo; Fujita, Yuka; Sakai, Mio; Nohara, Takahiro; Kawashima, Atsunari; Takahashi, Tohru; Tohda, Akira; Oka, Toshitsugu; Yamazaki, Hideya; Kuriyama, Keiko

doi:10.1016/j.brachy.2007.02.061

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Volume 6, Issue 3 , Pages 180-186, July 2007

New implant technique for separation of the seminal vesicle and rectal mucosa for high-dose-rate prostate brachytherapy

Ken Yoshida
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
- Corresponding author. Department of Radiology, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka-city, Osaka 540-0006, Japan. Tel.: +81-6-6942-1331; fax: +81-6-6943-6467.
Satoru Kuroda
- Department of Radiology, Sanda City Hospital, Hyogo, Japan
Mineo Yoshida
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Yuka Fujita
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Mio Sakai
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Takahiro Nohara
- Department of Urology, Kanazawa University Hospital, Ishikawa, Japan
Atsunari Kawashima
- Department of Urology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Tohru Takahashi
- Department of Urology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Akira Tohda
- Department of Urology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Toshitsugu Oka
- Department of Urology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Hideya Yamazaki
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Keiko Kuriyama
- Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan

Received 2 September 2006; received in revised form 10 January 2007; accepted 13 February 2007. published online 09 July 2007.

Abstract

Purpose

For safer treatment of seminal vesicles (SVs), we initiated a new technique using an anchor applicator for high-dose-rate interstitial brachytherapy (HDR-ISBT) of prostate cancer.

Methods and materials

Between January 2004 and March 2005, 23 intermediate- to high-risk patients were treated with HDR-ISBT as monotherapy. Transrectal ultrasonography guided implantation of the treatment applicator in and around the prostate gland and proximal SV. We used an “anchor” applicator to prevent posterior displacement of the SV. After insertion of the anchor applicator, the actual treatment applicator was implanted at the best position for optimal SV coverage. SV coverage was analyzed using a dose-volume histogram.

Results

Implantation of the applicator on the posterior side of the SV was successful for 43 of 46 SVs (93%). The median percentage of the SVs receiving the prescribed dose was 41% (range 11–86%). Only one case of acute Grade 2 toxicity (3%) was seen.

Conclusions

Our anchor applicator technique for HDR-ISBT can separate the SV from the rectum. This is the first report of dose-volume histogram analysis of the SV for HDR-ISBT.

Keywords: Prostate cancer, Seminal vesicle, implant technique, high-dose-rate interstitial brachytherapy