Prostate Brachytherapy UK & Ireland 11-12 June 2026

Oral and Poster Presentation – Clinical Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2017

Abstract number 4

Moving from 2 stage to intra-operative technique for LDR Brachytherapy

Thomas G*; Rye F*; Brock S*
*Poole Hospital NHS Foundation Trust

AIMS/INTRODUCTION: In October 2007 we started LDR prostate brachytherapy initially as a 2 stage procedure – treated 328 patients. March 2014 moved to a single intra-operative process using the Bard Prolink system. As on February 2017 we have treated 188 using the PROLINK.

The case for change: The 2 stage process – involved 2 GA’s , diffi cult to reproduce prostate position, as the implant progressed unable to adapt plan due to swelling. The intra-operative technique is a real time and adaptive giving greater fl exibility and improved dosimetry involving only one GA.

It did however create some challenges –

  • Took longer – the waiting list increased.
  • Theatre space also limited requiring additional staff and more equipment,
  • Increased radiation risk.

MATERIALS/METHODS: Overcoming the challenges: Detailed work fl ow study highlighted where improvements could be made.

  • Theatre space was maximised
  • Roles were clearly defi ned and the skill mix was interchangeable- giving greater fl exibility
  • Robust radiation seed accounting system was developed.

RESULTS: The service has now become streamlined which means 2 implants can be done per session. Waiting list now improved. Patients on average take 70 minutes to implant (including the time it takes to anaesthetise the patient). Prostate D90 is approved with this new technique with other dosimetric parameters remaining good.

CONCLUSION: Ergonomic design has maximised theatre space and a robust radiation accounting system has minimised risk. Defi ned roles within the team and has a good skill mix provides a supportive and fl exible service. The intra-operative procedure is now a quick technique – on average takes 70 minutes to implant a patient increasing capacity and reducing the waiting list. More convenient and safer for patients – only involves the one technique/GA. Dosimetry is maintained and perhaps improved – though this will require a fuller analysis there was no learning curve effect seen in the dosimetry.