Modified uniform seed loading for prostate brachytherapy: rationale, design, and evaluation.

PURPOSE: Despite a multitude of preplanning approaches and seed loading philosophies, multiple groups have reported comparable results in terms of biochemical disease-free survival and complication rates. None of the seed loading philosophies have been proven superior and no generally accepted loading philosophy has been adopted by the brachytherapy community.
MATERIALS AND METHODS: Review of the preplanning philosophy, preplanning dosimetry, and preimplant evaluation is presented.
RESULTS: A modified uniform seed loading approach is used because of its ability to deliver a relatively homogeneic dose to the prostate gland with a periprostatic margin, to routinely maintain the urethral dose at approximately 115% of the prescribed dose and to avoid significant rectal and urinary toxicity.
CONCLUSION: Of the commonly utilized seed loading philosophies, a modified uniform approach delivers a relatively homogeneic dose to the prostate gland/periprostatic region and is the most forgiving of local and systematic errors in seed placement.