Urethra low-dose tunnels: Validation of and class solution for generating urethra-sparing dose plans using inverse planning simulated annealing for prostate high-dose-rate brachytherapy

A urethral sparing-focused planning solution using IPSA reduces mean urethral dose by 34%, as compared with IPSA-generated plans based on the RTOG 0321 protocol. This is done while maintaining prostate coverage and critical structure dose. This technique can be applied to all patients in whom urethra toxicity is of particular concern.