ESTRO Brachytherapy for Prostate Cancer 2018

Measures to improve outcome and minimize risk of complications • Apply meticulous technique • Don’t drag seeds back into the rectal hump • Keep implant needles closest to the rectum at the prostato- rectal interface at least 5mm higher than the posterior prostatic boundry (c1 and d1 – use the 1.5 row rather) particularly in thin patients and prostates with longer sagittal measurements (long prostates – more than 8 slices) • Keep the urethra and TURP defect cooler than the periphery • Avoid implanting seeds into the urethra or TURP defect • If the seeds are too hot for the volume, use some cooler seeds even if they are just used for the rows closest to the rectum or urethra