Do theoretical potential and advanced technology justify the use of high-dose rate brachytherapy as monotherapy for prostate cancer?

Abstract

Low-dose rate brachytherapy (LDR-BT), involving implantation of radioactive seeds into the prostate, is an established monotherapy for most low-risk and select intermediate- and high-risk prostate cancer patients. High-dose rate brachytherapy (HDR-BT) is an advanced technology theorized to be more advantageous than LDR-BT from a radiobiological and radiophysics perspective, to the patient himself, and in terms of resource allocation. Studies of HDR-BT monotherapy have encouraging results in terms of biochemical control, patient survival, treatment toxicity and erectile preservation. However, there are still certain limitations that preclude recommending HDR-BT monotherapy for prostate cancer outside the setting of a clinical trial. HDR-BT monotherapy should be considered experimental at present.

Keywords::

• brachytherapy
• prostate cancer
• quality of life
• toxicity

Financial & competing interests disclosure

This work was supported in part by the Kimmel Cancer Center's NCI Cancer Center Support Grant P30 CA56036, as well as by Young Investigator Awards from the Prostate Cancer Foundation (RB Den). All authors have read and approved the manuscript. We have no financial disclosures and are not using any copyrighted information, patient photo-graphs, identifiers or other protected health information in this paper. No text, text boxes, figures or tables in this article have been previously published or owned by another party. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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