Prostate permanent implant brachytherapy with BARC I-125 Ocu-Prosta seeds

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Permanent prostate brachytherapy is a low-dose-rate treatment for localized prostate cancer.
• Iodine-125 (I-125) seeds are commonly used radioactive sources for this procedure.
• Establishing standardized protocols is crucial for safe and effective brachytherapy delivery.

Purpose of the Study:

• To implement and establish a standard operating procedure (SOP) for permanent prostate brachytherapy.
• To evaluate the use of BARC I-125 Ocu-Prosta seeds for this technique.
• To assess the feasibility of transrectal ultrasound (US)-guided implantation with intraoperative planning.

Main Methods:

• Transrectal ultrasound (US)-guided implantation using the Best Sonalis US Imaging System.
• Pre-implant dosimetry and intraoperative planning with the Best NOMOS Treatment Planning system.
• Implantation of BARC I-125 Ocu-Pro radioactive seeds using a Mick Applicator.

Main Results:

• Quality assurance tests were completed for the US system.
• A boost dose of 110 Gy was prescribed to a prostate volume of 34.71 cc.
• Approximately 48 seeds (0.35 mCi each) were implanted, with seed counts verified post-procedure.

Conclusions:

• Low-dose-rate permanent brachytherapy offers a one-time procedure with excellent outcomes and low morbidity.
• BARC supplies I-125 seeds suitable for Mick applicator implantation.
• While staff radiation exposure is a consideration, it can be minimized with good practice; this pilot study validates the SOP and implant system.