An approach of (1)
parallel-processing, (2) mitigation of possible errors/uncertainty, and (3) development
of tools and ideal setups were utilized to streamline the implantation,
treatment planning and treatment delivery processes.
Parallel-processing
consisted of simultaneous target and avoidance structure definition at a Velocity
workstation, BT catheter digitization at an Eclipse workstation, and
catheter-transfer tube-afterloader connections, with each process conducted by
a capable member of the care team.
Concern
regarding needle migration was reduced by employing a Diacor Zephyr patient
transfer system to safely and quickly transport the patient to the CT table and
to the BT vault without displacing BT catheters.
Standardized
templates for dose prescription, target/normal structure naming, planning optimization,
and plan objectives were utilized to accelerate and homogenize the treatment planning
process, enabling reproducible plan quality. Physics second checks were
facilitated through the creation and implementation of a custom Excel sheet. A
free-hand, non-fixed, non-stepper-stabilizer approach was employed by the implanting
radiation oncologist/urologist team, allowing for more freedom during the
implant and quicker setup/tear down times in the operating room (OR).