Kovács György, Pötter Richard, Loch Tillmann, Hammer Josef, Kolkman-Deurloo Inger-Karine, de la Rosette Jean J M C H, Bertermann Hagen
Interdisciplinary Brachytherapy Centre, University Hospital Schleswig-Holstein Campus Kiel, Arnold Heller Str 9, D-24105 Kiel, Germany.
Radiother Oncol. 2005 Feb;74(2):137-48. doi: 10.1016/j.radonc.2004.09.004.
The aim of this paper is to present the GEC/ESTRO-EAU recommendations for template and transrectal ultrasound (TRUS) guided transperineal temporary interstitial prostate brachytherapy using a high dose rate iridium-192 stepping source and a remote afterloading technique. Experts in prostate brachytherapy developed these recommendations on behalf of the GEC/ESTRO and of the EAU. The paper has been approved by both GEC/ESTRO steering committee members and EAU committee members.
Interstitial brachytherapy (BT) to organ confined prostate cancer can be applied as a boost treatment in combination with external beam radiation therapy (EBRT) using a proper number of BT fractions in curative intent. Temporary transperineal BT alone or in combination with EBRT are feasible as a palliative/salvage treatment modality because of local recurrence, however, without large clinical experience. The use of temporary BT as a monotherapy is subject of ongoing clinical research.
Recommendations for pre-treatment investigations, patient selection, equipment and facilities, the clinical team, the implant procedure (treatment planning and needle implantation) dose and fractionation, reporting, management of side effects and follow-up are given.
These recommendations are intended to be technically and advisory in nature, but the ultimate responsibility for the medical decision rests with the treating physician. Although, this paper represents the consensus of an interdisciplinary group of experts, TRUS and template guided temporary transperineal interstitial implants in prostate cancer are a constantly evolving field and the recommendations are subject to modifications as new data become available.
本文旨在介绍由GEC/ESTRO-EAU发布的关于使用高剂量率铱-192步进源和远程后装技术进行模板及经直肠超声（TRUS）引导下经会阴临时性间质内前列腺近距离治疗的推荐意见。前列腺近距离治疗领域的专家代表GEC/ESTRO和EAU制定了这些推荐意见。本文已获GEC/ESTRO指导委员会成员和EAU委员会成员批准。
对于局限于器官的前列腺癌，间质内近距离治疗（BT）可作为一种增效治疗，与外照射放疗（EBRT）联合应用，采用适当次数的BT分割，以达到治愈目的。单独或与EBRT联合的临时性经会阴BT作为姑息/挽救性治疗方式是可行的，因为存在局部复发情况，然而，目前尚无大量临床经验。将临时性BT作为单一疗法的应用是正在进行的临床研究课题。
给出了关于治疗前检查、患者选择、设备与设施、临床团队、植入操作（治疗计划和针植入）、剂量与分割、报告、副作用管理及随访的推荐意见。
这些推荐意见在本质上具有技术和咨询性质，但医疗决策的最终责任在于治疗医师。尽管本文代表了一个跨学科专家小组的共识，但TRUS和模板引导下的前列腺癌临时性经会阴间质内植入是一个不断发展的领域，随着新数据的出现，这些推荐意见可能会有所修改。
