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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References
- American Brachytherapy Society consensus guidelines for transrectal ultrasound-guided permanent prostate brachytherapy.Brachytherapy. 2012; 11: 6-19
- 103Pd Strings: Monte Carlo assessment of a new approach to brachytherapy source design.Med Phys. 2014; 41: 011716
- Experimental and Monte Carlo dosimetric characterization of a 1 cm 103Pd brachytherapy source.Brachytherapy. 2014; 13: 657-667
- Variability of prostate brachytherapy preimplant dosimetry: A multi-institutional analysis.Brachytherapy. 2005; 4: 241-251
- Stranded seed displacement, migration, and loss after permanent prostate brachytherapy as estimated by Day 0 fluoroscopy and 4-month postimplant pelvic x-ray.Brachytherapy. 2016; 3: 714-721
- A prospective randomized comparison of stranded vs. loose I-125 seeds for prostate brachytherapy.Brachytherapy. 2007; 6: 129-134
- Transperineal palladium 103 prostate brachytherapy: Analysis of morbidity and seed migration.Urology. 1995; 45: 87-92
- Complications following prostate brachytherapy.Eur Urol. 2002; 41: 427-433
- First report on the use of a thinner 125I radioactive seed within 20-gauge needles for permanent radioactive seed prostate brachytherapy: Evaluation of postimplant dosimetry and acute toxicity.Brachytherapy. 2013; 12: 375-381
- MRI-CT fusion to assess post brachytherapy prostate volume and the effects of prolonged edema on dosimetry following transperineal interstitial permanent prostate brachytherapy.Brachytherapy. 2004; 3: 55-60
- Evaluation of source displacement and dose-volume change after permanent prostate brachytherapy with stranded seeds.Radiother Oncol. 2007; 84: 190-196
- Decline of dose coverage between intraoperative planning and post implant dosimetry for I-125 permanent prostate brachytherapy: Comparison between loose and stranded seed plants.Radiother Oncol. 2009; 91: 202-206
- Incidence of seed migration to the chest, abdomen, and pelvis after transperineal interstitial prostate brachytherapy with loose I-125 seeds.Radiat Oncol. 2011; 6: 1
- Prostate brachytherapy seed migration and dosimetry: Analysis of stranded sources and other potential predictive factors.Brachytherapy. 2004; 3: 10-19
- Evaluation of the dosimetric impact of loss and displacement of seeds in prostate low-dose-rate brachytherapy.J Contemp Brachytherapy. 2015; 7: 203-210
Article info
Publication history
Published online: July 28, 2017
Accepted:
May 19,
2017
Received in revised form:
May 19,
2017
Received:
December 14,
2016
Footnotes
Conflict of interest: Drs. Kaminetsky and Beyer received compensation from CivaTech Oncology for the administration and enrollment of patients in this trial. Dr. Stock and Dr. Ge have received consulting fees from CivaTech Oncology.
Identification
Copyright
© 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
