Abstract
Abstract only
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Background: High Dose Rate (HDR) and Low Dose Rate ( LDR) prostate brachytherapy (PBT) with or without external beam radiotherapy provide excellent biochemical outcomes with practice adapting to ongoing research and technological advances. We wished to document current PBT practice in the UK and Ireland (UK & I) and compare with previous published audit results. Methods: A link to an online survey was communicated to centres attending the UK & I PBT conference in 2017 (n = 25). Sixty-three questions were grouped into six themed sections which included current experience, staffing, implant numbers (last 3 years), LDR pre / post implant dosimetry and HDR technique. Descriptive analysis was performed. Results: 18 of 25 centres responded (11 LDR only, 6 HDR & LDR, 1 HDR only) with 13 and 3 centres having > 10yrs experience with LDR and HDR respectively. 13 centres have two or more oncologists and 15 centres have two or more medical physics experts (MPE). 61% of lead clinicians performed > 25 implants with 22% performing > 50 in the year 2016. In the preceding 3 years, 44% of centres reported the number of LDR monotherapy cases as stable while 44% noted a reduction in numbers. Similarly 40% of centres reported LDR boost cases as stable, 40% as reduced and 20% with increased cases. The number of centres using HDR treatment as boost, monotherapy and salvage therapy has increased, with increased cases in the year 2016 as compared to 2014. Comparison with the UK 2012 audit showed that post implant LDR dosimetry is more consistently performed and the majority of cases were achieving the 3 defined quality standards of D90, V100 and CT:USS volume ratio. Average post implant D90 was > 145Gy in 63% of centres in 2014 and 2015 compared to 70% in 2016. 50% of centres reported average D90’s of > 155Gy in all three years surveyed. Conclusions: This survey offers a review of PBT practice across UK and I with an apparent fall in LDR monotherapy and boost cases but increase in HDR numbers noted. Surveyed centres report dosimetrically good quality implants. Current research supports PBT as a definitive primary treatment which should be discussed with eligible men at diagnosis.