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Interstitial rotating shield brachytherapy for prostate cancer.

Quentin E Adams1, Jinghzu Xu1, Elizabeth K Breitbach1

  • 1Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242.

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|May 3, 2014
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Summary

A novel interstitial rotating shield brachytherapy (I-RSBT) system using a (153)Gd source shows potential for reducing urethral dose in prostate cancer treatment. This technique offers significant dose reduction to critical organs compared to conventional high-dose-rate brachytherapy (HDR-BT).

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Area of Science:

  • Medical Physics
  • Radiation Oncology
  • Brachytherapy

Background:

  • Conventional interstitial high-dose-rate brachytherapy (HDR-BT) for prostate cancer can lead to significant dose exposure to surrounding organs.
  • Interstitial rotating shield brachytherapy (I-RSBT) is being explored as a method to improve dose distribution and spare organs at risk.

Purpose of the Study:

  • To introduce a new system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate.
  • To evaluate the dosimetric advantages of this novel I-RSBT system compared to conventional HDR-BT.

Main Methods:

  • A novel I-RSBT system was designed, featuring a wire-mounted 62 GBq (153)Gd source and a nitinol needle/catheter with a platinum shield.
  • Monte Carlo dose calculations were used to generate treatment plans for a prostate cancer patient, comparing I-RSBT with conventional HDR-BT.
  • Urethral dose was minimized by allowing a dose gradient volume within 0-5 mm of the urethra to receive less than the prescribed dose.

Main Results:

  • The platinum shield effectively reduced the dose rate on the shielded side.
  • I-RSBT reduced urethral D(0.1cc) by 29%-44% compared to conventional HDR-BT for a 0-5 mm urethral dose gradient volume.
  • Rectal and bladder D(1cc) were also reduced by 4%-7% with I-RSBT.

Conclusions:

  • The proposed (153)Gd-based I-RSBT system demonstrates potential for significantly lowering urethral dose in prostate cancer treatment.
  • A multi-source approach is required for the (153)Gd-based I-RSBT technique to achieve clinically relevant treatment times.