Permanent prostate seed implant brachytherapy: Report of the American Association of Physicists in Medicine Task Group No. 64

There is now considerable evidence to suggest that technical innovations, 3 D image-based planning, template guidance, computerized dosimetry analysis and improved quality assurance practice have converged in synergy in modern prostate brachytherapy, which promise to lead to increased tumor control a nd decreased toxicity. A substantial part of the medical physicist's contri bution to this multi-disciplinary modality has a direct impact on the facto rs that may singly or jointly determine the treatment outcome. It is theref ore of paramount importance for the medical physics community to establish a uniform standard of practice for prostate brachytherapy physics, so that the therapeutic potential of the modality can be maximally and consistently realized in the wider healthcare community. A recent survey in the U.S. fo r prostate brachytherapy revealed alarming variance in the pattern of pract ice in physics and dosimetry, particularly in regard to dose calculation, s eed assay and time/method of postimplant imaging. Because of the large numb er of start-up programs at this time, it is essential that the roles and re sponsibilities of the medical physicist be clearly defined, consistent with the pivotal nature of the clinical physics component in assuring the ultim ate success of prostate brachytherapy, It was against this background that the Radiation Therapy Committee of the American Association of Physicists i n Medicine formed Task Group No. 64, which was charged (I) to review the cu rrent techniques in prostate seed implant brachytherapy, (2) to summarize t he present knowledge in treatment planning, dose specification and reportin g, (3) to recommend practical guidelines for the clinical medical physicist , and (4) to identify issues for future investigation. (C) 1999 American As sociation of Physicists in Medicine. [S0094-2405 (99)00910-4].