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2018 ; 7
(3
): 341-356
Nephropedia Template TP
Stish BJ
; Davis BJ
; Mynderse LA
; McLaren RH
; Deufel CL
; Choo R
Transl Androl Urol
2018[Jun]; 7
(3
): 341-356
PMID30050795
show ga
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.
free
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