Prostate brachytherapy in obese patients.
OBJECTIVE
To identify and illustrate the potential problems with brachytherapy in obese patients.


METHODS
Three patients with body mass index greater than 30 were treated with prostate brachytherapy. Transrectal ultrasound (TRUS) was performed using a 6.0-MHz Siemens Sonoline Prima ultrasound machine and a Barzell-Whitmore stepper unit. The patients' weight required use of an accessory table support.


RESULTS
Once set up, there was ample room to maneuver, providing that the patient's legs were abducted fully. TRUS imaging of the prostate was unaffected by patients' obesity. The amount of periprostate adipose tissue visualized on TRUS appeared to be no different than that noted in nonobese patients. Similarly, there was no increased distance between the prostate and rectal surface, either on preimplant CT or transverse TRUS. To date, our experience is that the perineal skin to prostate distance was not so great that standard 20-cm applicator needles could not be used. For the 2 sub-350-pound patients who could be imaged on our CT scanner, postimplant target coverage (V100) was 88% and 95%.


CONCLUSIONS
Standard TRUS and brachytherapy needles are sufficient to implant even the largest patients.
Rockhill
Jason
J
Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
Wallner
Kent
K
Hoffman
Cory
C
Merrick
Gregory
G
Simpson
Colleen
C
Arthurs
Sandra
S
D001918:Brachytherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011471:Prostatic Neoplasms / Q000150:complications / Q000532:radiotherapy*