Reviewers: Li Liu, MD
Source: International Journal of Radiation Oncology Biology Physics, 44(4): 789-799, July 1999
The proportion of patients treated by permanent brachytherapy has been increasing rapidly in the past few years due to relatively low morbidity, good 10-year outcome, and better public awareness. The American Brachytherapy Society (ABS) published the updated recommendations for transperineal permanent brachytherapy of prostate cancer.
The ABS recommends that dosimetric planning of the implant be carried out for all patients before seed insertion. The ABS endorses the use of the American Association of Physics and Medicine (AAPM) Task Group No. 43 (TG-43) recommendation for 125I dosimetry. The recommended dose for 125I (TG-43) and 103Pd are 144Gy and 115-120Gy, respectively when brachytherapy is used as monotherapy. For a brachytherapy boost, the recommended dose is 100-110Gy and 80-90Gy, respectively. The ABS has no preference of one radionuclide over the other.
Postoperative dosimetry is recommended for all patients using various techniques. Reports should include the prescribed dose, the dose that covers 100% and 90% of the prostate volume (D100 and D90), and the percentage of prostate volume that received the prescribed dose (V100). Close postoperative follow-up with digital rectal examinations (DRE) and PSA at regular intervals is recommended.