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[Brachytherapy for prostate carcinoma].

[Article in Japanese]

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Department of Radiology, Tokyo Medical Center, National Hospital Organization.


This review aims to provide an overview of prostate brachytherapy and disseminate consensus guidelines formed by the American Brachytherapy Society. In Japan, permanent transperineal prostate brachytherapy with I-125 started in September 2003. Patients with high probability of organ-confined disease are appropriately treated with brachytherapy. Brachytherapy candidates with a significant risk of extraprostatic extension should be treated with supplemental external beam radiation therapy. The recommended prescription doses for monotherapy are 145 Gy. The corresponding boost doses after 40-50 Gy of external beam are 100-110 Gy. Dosimetric planning of the implant should be carried out for all patients before seed insertion. Post-implant dosimetry and evaluation must be performed on all patients. A dose-volume histogram of the prostate should be performed. The dose that covers 90% of the prostate volume, the percentage of prostate volume receiving 100%, 150%, and 200% of the prescribed dose, and the rectal dose and urethral dose should be reported. ABS recommends standardization of the reporting of brachytherapy-related prostate morbidity, including urinary, rectal, and sexual function. These morbidities should be correlated with the doses to normal tissues. High-dose-rate (HDR) brachytherapy with Ir- 192 has preceded seed implants in Japan. HDR has some theoretical advantages. We should develop techniques of both types of brachytherapy in Japan.

[Indexed for MEDLINE]

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