Effectiveness of Rotating Shield Brachytherapy for Prostate Cancer Dose Escalation and Urethral Sparing

A 26-patient treatment planning study comparing rotating shield brachytherapy (RSBT) to conventional high-dose-rate brachytherapy (HDR-BT) for dose escalation, simulating monotherapy, and urethra sparing, simulating boost therapy. The radiobiological effects of dose protraction and source age were accounted for. RSBT can increase PTV EQD90% or decrease urethral D10% relative to HDR-BT at the cost of increased treatment time. Source aging reduces RSBT benefit, but RSBT remains theoretically superior to HDR-BT by >20% after one-half-life has elapsed.

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