Better standardization of the physics of brachytherapy

The use of radiation to treat cancer is highly dependent on a detailed appreciation of the physics that underlies the medical application of radioactivity. A new set of guidelines from the American Association for Physicists in Medicine (AAPM) provides technical guidance on prostate brachytherapy procedures and recommends that there should be careful, well-documented, post-implant analysis of the actual dose of radiation delivered to the prostate and nearby organs for every brachytherapy patient and procedure.

The guideline is to be published in the November 2009 issue of Medical Physics, but it is also available on line for the technically interested.

The guideline clearly states the need for developing a consensus methodology for dose prescription and reporting of actual dose delivery for prostate brachytherapy. The AAPM Task Group 137’s new recommendations encompass such matters as the timing, imaging techniques, dose planning criteria, and dose evaluation parameters that should be followed in documenting each brachytherapy treatment. The group’s primary objective was to encourage consistent and reproducible methods for reporting of dosimetric information without increasing health-care costs.

In an article in The Medical News based on a recent media release, Yan Yu, MD stated that “Sophisticated brachytherapy techniques such as real-time planning, image-guided robotic implantation and dynamic dose verification are either here or imminent. The field requires a higher level of standardization, which is exactly what Task Group 137 was commissioned to address.”

A prior guideline (issued a decade ago) outlined technical issues related to prostate cancer brachytherapy when the technique was in its relative infancy. With broad use of this technique today, better standardization will help to ensure higher quality of the procedures over time.

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