Brachytherapy in Prostate Cancer: The use of QuickLink^® System Within the Real-Time Technique. A New Technique is Presented

Abstract

CaP clinical stage T1-T2, PSA ≤10 ng/ml, prostate volume ≤ 50g, Gleason score ≤3+3=6, Q maximum >13-15 ml/sec., and I-PSS score <10. METHODICAL. In ultrasound-guided transrectal technique the needles are inserted near the prostatic capsule. A 5mm section plan is performed; the computer allows identifying the contours of prostate, rectum, urethra, and the position of needles to be inserted. The total activity is defined, as well as the number and location of the sources to be included; isodoses are calculated, the correct position of seeds and spacers is printed. The strand seeds are prepared on the basis of this scheme, using the QuickLink® system, and placed into the prostate tissue. RESULTS. The QuickLink® system allows reducing the operative time (110 min, range 95-125). The pelvic CT assessing the post-planning has shown a more regular distribution of seeds. The cut-off of D90≥140 Gy was reached in all patients, with doses at urethra and rectum within the prescribed limits. CONCLUSIONS. The brachytherapy real-time with strand seeds QuickLink® combines the flexibility of planning intraoperative real-time with a faster process, and less tendency for the relocation of the seeds.

Salvage Low-Dose-Rate Brachytherapy for Prostate Cancer Local Recurrence after Radical Prostatectomy: Our First three Patients

“…Furthermore, the insertion of the needles must be performed very carefully due to the small dimension and the critical position of the target. Finally, as already reported and confirmed by our present experience, the use of stranded seeds, which provides a more stable seed envelope and prevents their migration or displacement, seems to be much more useful in these cases due to the asymmetry and irregularity of the local recurrence (13, 19, 26). This aspect would also suggest the importance of skill in the use of stranded seeds in order to achieve better results with lower morbidity.…”