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Performance of a palladium-103 line source for prostate brachytherapy implants: A Phase I trial

      Abstract

      Purpose

      To evaluate the use of a polymer-encapsulated palladium-103 (103 Pd) source with a unique linear radioactive distribution in prostate brachytherapy. This feasibility study assessed dosimetry, ease and efficiency of use, and side effects. The number of needles required for adequate coverage was the primary end point.

      Methods and Materials

      CivaString 103 Pd Model CS10 implants were preplanned for 25 patients. CivaStrings were custom manufactured according to plan. CivaStrings were implanted with 18 gauge needles. Post-implant dosimetry was performed at 3-6 weeks.

      Results

      Monotherapy (125 Gy) was prescribed for 11 implants. External beam radiation with CivaString boost (100 Gy) was prescribed for 14 implants. The mean time to implant the sources was 23.5 min. The number of planned needles and prostate sizes ranged from 14 to 25 and 21-101 cm3, respectively. 70% of implants in prostates less than 50 cm3 required ≤17 needles. Planned source strength ranged from 2.8 U/cm to 3.9 U/cm. Total source strength averaged 216 U (130-323 U) for monotherapy and 154 U (92.4-245 U) for boost. Nomograms were generated at both prescription dose levels.

      Conclusions

      The linear 103Pd source provides good dose coverage to the prostate. Prostate volume changes were minimal suggesting minimal swelling using the CivaString device.

      Keywords

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