Permanent prostate brachytherapy preplanned technique: The modern Seattle method step-by-step and dosimetric outcomes.
OBJECTIVE
To describe, step-by-step, the current Seattle preplan technique, and report the dosimetric outcomes on 1,131 consecutively such treated prostate brachytherapy patients.


METHODS
One thousand one hundred thirty one patients with prostate cancer were treated with iodine-125 ((125)I), palladium-103 ((103)Pd), or cesium-131 ((131)Cs) using a preplanned template-guided transrectal ultrasound-guided approach between January 2005 and August 2007. Day one computed tomography (CT) scans were taken for postimplantation dose-volume histogram evaluations. Postoperative prostate contours were drawn by one author (DN) on CT images taken on postoperative day one.


RESULTS
The volume of prostate receiving 100% of prescription dose (V(100)) and percent dose to 90% of the prostate (%D(90)) were 95% and 106% for 558 monotherapy (125)I implants, 91% and 102% for 327 (103)Pd implants, and 97% and 111.5% for 13 (131)Cs implants, respectively. The median V(100) and percent D(90) were 91% and 101% for five boost (125)I implants, 92% and 104% for 228 boost (103)Pd implants. The median rectal volume receiving 100% of prescription dose (RV(100)) for (125)I, (103)Pd, and (131)Cs monotherapy implants were 0.3, 0.13, and 0.38cc, and for (125)I and (103)Pd boost implants were 0.16 and 0.13cc, respectively. No patient received an RV(100) of >0.92cc.


CONCLUSIONS
Modern preplanned template and ultrasound-guided prostate brachytherapy can consistently result in excellent prostate dosimetry and rectal sparing.
Seattle Prostate Institute, Swedish Medical Center, Seattle, WA. Electronic address: johnsylvester@seattleprostate.com.
John E
JE
Sylvester
Seattle Prostate Institute, Swedish Medical Center, Seattle, WA.
Peter D
PD
Grimm
Seattle Prostate Institute, Swedish Medical Center, Seattle, WA.
Stephen M
SM
Eulau
Seattle Prostate Institute, Swedish Medical Center, Seattle, WA.
Robert K
RK
Takamiya
Seattle Prostate Institute, Swedish Medical Center, Seattle, WA.
Devi
D
Naidoo
D001918:Brachytherapy / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D019160:Endosonography / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging / Q000379:methods; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014861:Washington