[Improvement of interstitial brachytherapy for localized prostate neoplasms with a new implantation technique].

PURPOSE

The success of an interstitial brachytherapy treatment is based on the correct implantation geometry. Frequently, deviations of top needle vs. template coordinates were observed by transrectal sonography of 358 high-dose-rate (HDR) implantations for prostate cancer.

PATIENTS AND METHODS

In cooperation with the companies BIP GmbH and Isotopen-Technik Dr. Sauerwein GmbH we developed a high-speed implantation machine, which was tested by 22 interstitial prostate applications. We compared the manual needle positioning method to the high-speed machine and observed the sequence of needle deviation as well as the acute postoperative side effects (hematoma, macroscopic hematuria, pain and urin stop).

RESULTS

Using the manual implantation method (n = 12) 43.8% of all implanted needles (42 out of 96, mean 3.5) showed a deviation vs. 3.6% (3 out of 83, mean 0.3) by the use of the high-speed device (n = 10). Acute postoperative side effects according to the implantation were: urin stop (3 vs. 0), macroscopic hematuria (3 vs. 1), and pain (4 vs. 1), respectively.

CONCLUSION

The use of a modified high-speed biopsy device for the interstitial brachytherapy results in a higher accuracy in the needle positioning and in reproducing pretreatment implantation plans. Because of the good clinical experience we introduced the high-speed implantation device into our clinical routine.