A definitive radiotherapy dose for localized prostate cancer can be safely administered using high-dose rate (HDR) brachytherapy as a single, outpatient, minimally-invasive procedure, according to the results of a prospective, nonrandomized clinical trial published recently in the International Journal of Radiation Oncology, Biology, and Physics (2017; 97:98-106).
Brachytherapy has long been an accepted local therapy for prostate cancer, according to first author Daniel J. Krauss, MD, of Oakland University William Beaumont School of Medicine, Royal Oak, MI.
“Permanent-seed, or low-dose-rate brachytherapy has historically been the more commonly administered treatment and has the advantage of being delivered in a single outpatient surgery, but patients are required to manage the responsibility and inconvenience of carrying radioactive material in their pelvis for several months following the procedure. HDR brachytherapy has a couple of advantages over permanent-seed brachytherapy, including the fact that the patient is not radioactive following the procedure as well as suggestion of reduced rectal toxicity,” Dr. Krauss told Urology Times.
HDR may also be preferred because physicians maintain more control over dose deposition in the prostate because the entire treatment is delivered under his/her direct control, along with theoretical biologic benefit of large, fractional dose delivery felt to be advantageous in the treatment of prostate cancer, Dr. Krauss explained. However, a drawback of HDR brachytherapy, historically, has been the complexity of its administration. Namely, HDR is typically administered in multiple treatment fractions, frequently requiring multiple invasive procedures to complete an entire course of treatment.
“By administering the entire dose in a single-treatment fraction, efficiency is maximized, cost is minimized, and risk to the patient reduced through fewer invasive procedures and minimal exposure to anesthesia,” Dr. Krauss said.