Prescription dose in permanent (131)Cs seed prostate implants

Recently, 131Cs seeds have been introduced for prostate permanent seed implants. This type of seed has a relatively short half-life of 9.7 days and has its most prominent emitted photon energy peaks in the 29-34 keV region. Traditionally, 145 and 125 Gy have been prescribed for 125I and 103Pd seed prostate implants, respectively. Since both the half-life and dosimetry characteristics of 131Cs seed are quite different from those of 125I and 103Pd, the appropriate prescription dose for 131Cs seed prostate implant may well be different. This study was designed to use a linear quadratic radiobiological model to determine an appropriate dose prescription scheme for permanent 131Cs seed prostate implants. In this model, prostate edema was taken into consideration. Calculations were also performed for tumors of different doubling times and for other related radiobiological parameters of different values. As expected, the derived prescription dose values were dependent on type of tumors and types of edema. However, for prostate cancers in which tumor cells are relatively slow growing and are reported to have a mean potential doubling time of around 40 days, the appropriate prescription dose for permanent 131Cs seed prostate implants was determined to be: 127(+5)(-12)Gy if the experiences of 125I seed implants were followed and 121(+0)(-3)Gy if the experiences of 103Pd followed.