GEC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer.
OBJECTIVE
The aim of this paper is to present the GEC/ESTRO-EAU recommendations for template and transrectal ultrasound (TRUS) guided transperineal temporary interstitial prostate brachytherapy using a high dose rate iridium-192 stepping source and a remote afterloading technique. Experts in prostate brachytherapy developed these recommendations on behalf of the GEC/ESTRO and of the EAU. The paper has been approved by both GEC/ESTRO steering committee members and EAU committee members.


METHODS
Interstitial brachytherapy (BT) to organ confined prostate cancer can be applied as a boost treatment in combination with external beam radiation therapy (EBRT) using a proper number of BT fractions in curative intent. Temporary transperineal BT alone or in combination with EBRT are feasible as a palliative/salvage treatment modality because of local recurrence, however, without large clinical experience. The use of temporary BT as a monotherapy is subject of ongoing clinical research.


RESULTS
Recommendations for pre-treatment investigations, patient selection, equipment and facilities, the clinical team, the implant procedure (treatment planning and needle implantation) dose and fractionation, reporting, management of side effects and follow-up are given.


CONCLUSIONS
These recommendations are intended to be technically and advisory in nature, but the ultimate responsibility for the medical decision rests with the treating physician. Although, this paper represents the consensus of an interdisciplinary group of experts, TRUS and template guided temporary transperineal interstitial implants in prostate cancer are a constantly evolving field and the recommendations are subject to modifications as new data become available.
Kovács
György
G
Interdisciplinary Brachytherapy Centre, University Hospital Schleswig-Holstein Campus Kiel, Arnold Heller Str 9, D-24105 Kiel, Germany.
Pötter
Richard
R
Loch
Tillmann
T
Hammer
Josef
J
Kolkman-Deurloo
Inger-Karine
IK
de la Rosette
Jean J M C H
JJ
Bertermann
Hagen
H
D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D000075202:Contraindications; D019583:Dose Fractionation, Radiation; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D009367:Neoplasm Staging; D010166:Palliative Care; D018579:Patient Selection; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000517:prevention & control; D012007:Rectum / Q000000981:diagnostic imaging; D016879:Salvage Therapy; D014463:Ultrasonography
D007496:Iridium Radioisotopes