ABSTRACT
Although current prostate brachytherapy is widely accept-ed, it still suffers from limitations and variability that have limited its full potential. Progress in overcoming limitations is being made in a number of laboratories and companies by addressing factors such as:
The patient’s anatomy. Pubic arch interference (PAI) with the implant path occurs in many patients with large pro-states (>60 cm3) and even in some patients with prostates <40 cm3. These patients cannot be treated with conven-tional brachytherapy with parallel needle trajectories guided by the conventional brachytherapy template, as the anterior and/or the anterolateral parts of the prostate are blocked by the pubic bone.1-3 In this chapter, we describe a robot-aided approach, which removes the paral-lel needle trajectory constraint of the template, allowing patients with PAI to be treated with brachytherapy without undergoing additional lengthy hormonal therapy to shrink the prostate.
