Brachytherapy cases were randomly selected for review and data abstraction using lists of eligible patients provided by the treating facilities. Eligibility criteria for

inclusion in the survey were as follows: (1) biopsy-proven adenocarcinoma of the prostate, (2) treatment that consisted of a permanent interstitial implantation, (3) treatment received Sirolimus mw during 1 year (2007), and (4) treatment in which the use of androgen-deprivation therapy in conjunction with radiotherapy was acceptable. Patients who had a prior radical prostatectomy or were treated for recurrent/metastatic disease were excluded. The characteristics of these patients as well as brachytherapy treatment details are summarized

in Tables 1 and 2. Trained research associates performed onsite reviews PD98059 cell line of the medical records of selected cases. Information about patient characteristics; tumor characteristics; staging workup; and brachytherapy treatment details, including isotope, seed strength, number of seeds, and PD, were collected and recorded in an online database. Digital Imaging and Communications in Medicine CT images, contours of the prostate and rectum, and radiation dose files (which were extracted from a variety of treatment planning systems) were remotely deidentified and submitted from the sites to a control center at the Image-Guided Therapy QA center (ITC) located in St. Louis, MO. The deidentified CT images were then uploaded from the ITC to a treatment planning system (Variseed Varian Brachytherapy, Charlottesville, VA) at the reference expert institution

for this study (Memorial Sloan–Kettering Cancer Center) where the prostate and rectal anatomy were recontoured by one physician (LM) and checked carefully for accuracy by another (MJZ). Because these CT scans were obtained 2–6 weeks after the ADP ribosylation factor implantation procedure, a urinary catheter was not in place and delineation of the urethra for contouring purposes was not obtained. Based on the new contours and the seed locations, dose–volume histograms were generated and dosimetric evaluation was performed for each of these cases. Dosimetric parameters analyzed included %V100 prostate (percent volume of the prostate that received the PD), D90 prostate (dose delivered to 90% of the prostate expressed in percent of the PD), %V150 prostate (percent volume of the prostate that received 150% of the PD), V100 rectum (percent volume of the rectum that received the PD), and D2cc rectum (dose to 2 cc of the rectum expressed in percent of the PD).