Medical Professionals Online

Long-term Results And Overview Of Brachytherapy

November 14, 2017

In the online version of the World Journal of Urology, Dr. Stefan Machtens and colleagues present a review of brachytherapy with a European perspective.

Brachytherapy for prostate cancer (CaP) is performed with permanent radioisotopes Iodine-125 or Palladium-103. I-125 has a half-life of 60 days and the radioactive decay will occur over 1 year following the implant. Pd-103 has a half-life of 17 days. Compared to external beam radiotherapy, the radiobiological equivalent dose of seed implantation is 100-120Gy.

Planning is performed with transrectal ultrasound, either prior to or at the start of the implant procedure. Seed distribution can be by two techniques, one distributing seeds equally throughout the gland, but the more favored method giving a peripheral loading to reduce the central urethral dose. Seeds are placed in a longitudinal view from the base to the apex. Post-implant dosimetry evaluates the implant quality and is performed by CT scanning one month after the treatment session to permit edema to subside.

Indications for brachytherapy include patients with CaP, stage