Poster Presentation – Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2013

Abstract number 9

Can a Mentored Training Program Help Overcome the Learning Curve for Prostate Seed Brachytherapy? Initial Experience at a Single Irish Centre

Paul J Kelly
Cork University Hospital, Ireland
Suzanne Kelleher
Cork University Hospital, Ireland
Admire Dzingwa
Cork University Hospital, Ireland
Ted J Fitzgerald
Cork University Hospital, Ireland
Jennifer Gilmore
Cork University Hospital, Ireland
Frank Sullivan
University Hospital Galway, Ireland

Aims/Introduction: Prostate Seed Brachytherapy (PSB) was introduced at Cork University Hospital in July 2012 as part of the National Brachytherapy Programme. This followed a mentored training program for clinicians, physicists and nurses led by University Hospital Galway. The Mentee Radiation Oncologist firstly observed 10 cases performed by the Mentor. Thereafter the Mentee performed a further 10 cases as the chief operator, observed closely by the mentor. The technique utilized is an Iodine-125 loose-seed nomogram-based technique with real-time dosimetry. The purpose of this study was to review the dosimetry from the 24 cases performed to date, including the initial 10 mentored cases [Group 1] and the subsequent 14 solo cases [Group 2].

Materials/Methods: We retrospectively reviewed prospectively collected data from the first 24 prostate seed brachytherapy implants performed at Cork University Hospital. Day 30 CT dosimetric parameters including V100, V150, D90, VR100 are reported. Intra-op ultrasound-based urethral D30 is also reported. Dosimetric parameters for mentored cases [Group1] and subsequent cases [Group 2] were also compared.

Results: The median prostate volume implanted was 31cc (IQR 23.1-34.6). The median (IQR) Day 30 CT prostate V100, V150 and D90 were 95.6% (92.1-96.9), 50.4% (45.9-54) and 174.7Gy (163.5-184) respectively. Median Rectal V100 was 0.3cc (0.2-0.7). The median (IQR) intra-op urethral D30 was 177.4Gy (175.5-180). No statistically significant differences were observed between Group 1 and Group 2 V100 (p=0.14) or D90 (p=0.09).

Conclusions: Satisfactory dosimetry was achieved following a structured mentorship program. No significant differences in dosimetry were observed between mentored cases and subsequent un-mentored cases. Initial dosimetry achieved supports mentored training programs for PSB.