Open AccessLow dose rate prostate brachytherapy
Author(s) -
Bradley J. Stish,
Brian J. Davis,
Lance A. Mynderse,
Robert H. McLaren,
Christopher L. Deufel,
Richard Choo
Publication year - 2018
Publication title -
translational andrology and urology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.721
H-Index - 27
eISSN - 2223-4691
pISSN - 2223-4683
DOI - 10.21037/tau.2017.12.15
Subject(s) - brachytherapy , medicine , prostate cancer , genitourinary system , androgen deprivation therapy , prostate , prostate brachytherapy , radiation therapy , external beam radiation , external beam radiotherapy , radiation treatment planning , urology , radiology , medical physics , oncology , cancer
Low dose rate (LDR) prostate brachytherapy is an evidence based radiation technique with excellent oncologic outcomes. By utilizing direct image guidance for radioactive source placement, LDR brachytherapy provides superior radiation dose escalation and conformality compared to external beam radiation therapy (EBRT). With this level of precision, late grade 3 or 4 genitourinary or gastrointestinal toxicity rates are typically between 1% and 4%. Furthermore, when performed as a same day surgical procedure, this technique provides a cost effective and convenient strategy. A large body of literature with robust follow-up has led multiple expert consensus groups to endorse the use of LDR brachytherapy as an appropriate management option for all risk groups of non-metastatic prostate cancer. LDR brachytherapy is often effective when delivered as a monotherapy, although for some patients with intermediate or high-risk disease, optimal outcome are achieved in combination with supplemental EBRT and/or androgen deprivation therapy (ADT). In addition to reviewing technical aspects and reported clinical outcomes of LDR prostate brachytherapy, this article will focus on the considerations related to appropriate patient selection and other aspects of its use in the treatment of prostate cancer.