High dose rate prostate brachytherapy: an overview of the rationale, experience and emerging applications in the treatment of prostate cancer

Abstract

The technological advances in real-time ultrasound image guidance for high dose rate (HDR) prostate brachytherapy places this treatment modality at the forefront of innovation in radiotherapy. This review article will explore the rationale for HDR brachytherapy as a highly conformal method of dose delivery and safe dose escalation to the prostate, in addition to the particular radiobiological advantages it has over low dose rate and external beam radiotherapy. The encouraging outcome data and favourable toxicity profile will be discussed before looking at emerging applications for the future and how this procedure will feature alongside stereotactic radiosurgery.

Men’s Experience of Virtual Simulation to Aid Patient Education for Radiation Treatment to the Prostate

“…Brachytherapy enables the delivery of high dose radiation to the prostate in a single treatment and reduces the total number of external beam radiation treatments a patient will require (Challapalli, Jones, Harvey, Hellawell, & Mangar, 2012). Patients who are suitable for brachytherapy may be offered this treatment before receiving a course of VMAT radiation treatment at WBCC.…”

CT-on-Rails-Guided HDR Brachytherapy: Single-Room, Rapid-Workflow Treatment Delivery with Integrated Image Guidance

“…Highdose-rate (HDR) brachytherapy is increasingly favored in contemporary radiation therapy clinics over low-dose-rate brachytherapy, since it improves patient convenience, reduces exposure of staff to radiation, reduces the risks of adverse events associated with prolonged immobilization (e.g., blood clots), and avoids the need for shielded hospital rooms for prolonged stays [1]. There is an overall trend towards image-guided brachytherapy with the use of 3D imaging for applicator placement, delineation of target volumes, as well as adjacent normal tissue structures and treatment planning [2][3][4][5].…”

BJRbrachytherapy dosimetry special feature

“…As examples, in high-dose-rate prostate brachytherapy, technological advances in real-time ultrasound image guidance and live patient-specific optimization places the treatment modality at the forefront of innovation in radiotherapy. 3 In low-dose-rate brachytherapy for the prostate, recent years have seen an evolution from the traditional two-stage technique to a single session with interactive planning and seed delivery in theatre, hence removing a main source of uncertainty. 4 In cervical cancer, the past decade has seen a step change from two-dimensional to three-dimensional image-guided brachytherapy, with various uses of fluoroscopy, ultrasound, CT, MRI and positron emission tomography.…”