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Low Dose Rate ( LDR ) Prostate Brachytherapy?

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Low Dose Rate (LDR) Prostate Brachytherapy

Introduction
According to the American Cancer Society, nearly 161,360 new cases of prostate cancer are expected to be diagnosed with an estimated 26,730 prostate-cancer specific deaths in 2017. Prostate cancer is the third leading cause of cancer death in American men, behind lung and colorectal cancer. Current available treatments for prostate cancer include active surveillance, surgery, radiation therapy (external beam or/and brachytherapy), cryosurgery, hormone therapy, chemotherapy, vaccine treatment or bone directed treatment. This paper will discuss the implementation of low dose rate (LDR) brachytherapy for treatment of prostate cancer. It will discuss available sources and equipment
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Pd-103 has a half-life of 17 days and emits characteristic xrays of 20.1 keV and 23 keV. The half value layer in lead is 0.008mm. More recently, Cesium-131 sources have been utilized. The shorter half-life and higher dose rate of Cs-131 may offer both practical and radiobiological benefits but long -term outcomes have not been evaluated.
The facility must have a way to independently verify the source strength and activity provided by the manufacturer. Source strength and activity measurement must be done with a well ionization chamber and electrometer or other suitable instrument with a calibration directly traceable to the National Institute of Standards and Technology (NIST). Calibrated survey instruments must also be available for use at and back up survey meter must be readily available in case of primary instrument failure. The facility must have instrumentation to perform periodic sealed-source leak testing. Appropriate local shielding, storage facilities, transportation containers, manipulation devices, and storage containers for emergency use must also be available. A computerized treatment planning system for volumetric image guidance (CT, ultrasound, etc), applicator reconstruction, and isodose computation must be available to calculate point doses, to generate isodose distributions, and to compute dose-volume statistics.
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