High-dose-rate brachytherapy as monotherapy for prostate cancer: technique, rationale and perspective

High-dose-rate (HDR) brachytherapy as monotherapy is a comparatively new brachytherapy procedure for prostate cancer. Although clinical results are not yet mature enough, it is a highly promising approach in terms of potential benefits for both radiation physics and radiobiology. In this article, we describe our technique for monotherapeutic HDR prostate brachytherapy, as well as the rationale and theoretical background, with educational intent.

[1]  Y. Yoshioka,et al.  High-dose-rate brachytherapy as monotherapy for localized prostate cancer: a retrospective analysis with special focus on tolerance and chronic toxicity. , 2003, International journal of radiation oncology, biology, physics.

[2]  G. Gustafson,et al.  High-Dose-Rate Prostate Brachytherapy: An Excellent Accelerated-Hypofractionated Treatment for Favorable Prostate Cancer , 2010, American journal of clinical oncology.

[3]  D. Brenner,et al.  Direct evidence that prostate tumors show high sensitivity to fractionation (low alpha/beta ratio), similar to late-responding normal tissue. , 2002, International journal of radiation oncology, biology, physics.

[4]  R. Pötter,et al.  GEC/ESTRO-EAU recommendations on temporary brachytherapy using stepping sources for localised prostate cancer. , 2005, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[5]  J. Skowronek.  Low-dose-rate or high-dose-rate brachytherapy in treatment of prostate cancer – between options , 2013, Journal of contemporary brachytherapy.

[6]  D. Brenner,et al.  Direct evidence that prostate tumors show high sensitivity to fractionation (low α/β ratio), similar to late-responding normal tissue , 2002 .

[7]  G. Gustafson,et al.  Phase II prospective study of the use of conformal high-dose-rate brachytherapy as monotherapy for the treatment of favorable stage prostate cancer: a feasibility report. , 2001, International journal of radiation oncology, biology, physics.

[8]  Glen Gejerman,et al.  Analysis of serial CT scans to assess template and catheter movement in prostate HDR brachytherapy. , 2004, International journal of radiation oncology, biology, physics.

[9]  J. Hendry,et al.  Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: α/β = 1.4 (0.9-2.2) Gy. , 2012, International journal of radiation oncology, biology, physics.

[10]  P. Hoskin,et al.  High dose rate afterloading brachytherapy for prostate cancer: catheter and gland movement between fractions. , 2003, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[11]  Ken Yoshida,et al.  Needle applicator displacement during high-dose-rate interstitial brachytherapy for prostate cancer. , 2010, Brachytherapy.

[12]  P. Hoskin,et al.  High-dose-rate brachytherapy alone for localized prostate cancer in patients at moderate or high risk of biochemical recurrence. , 2012, International journal of radiation oncology, biology, physics.

[13]  M. Ghilezan,et al.  High-dose-rate brachytherapy as monotherapy delivered in two fractions within one day for favorable/intermediate-risk prostate cancer: preliminary toxicity data. , 2012, International journal of radiation oncology, biology, physics.

[14]  Iori Sumida,et al.  Optimization of dose distribution for HDR brachytherapy of the prostate using Attraction-Repulsion Model. , 2006, International journal of radiation oncology, biology, physics.

[15]  Y. Yoshioka,et al.  The emerging role of high-dose-rate (HDR) brachytherapy as monotherapy for prostate cancer , 2013, Journal of radiation research.

[16]  J. Pouliot,et al.  Dosimetric impact of interfraction catheter movement in high-dose rate prostate brachytherapy. , 2011, International journal of radiation oncology, biology, physics.

[17]  P. Hoskin,et al.  A Phase II study of high-dose-rate afterloading brachytherapy as monotherapy for the treatment of localized prostate cancer. , 2008, International journal of radiation oncology, biology, physics.

[18]  J. Pouliot,et al.  American Brachytherapy Society consensus guidelines for high-dose-rate prostate brachytherapy. , 2012, Brachytherapy.

[19]  X. Allen Li,et al.  HOW LOW IS THE / RATIO FOR PROSTATE CANCER? , 2003 .

[20]  J. Fowler,et al.  Is alpha/beta for prostate tumors really low? , 2001, International journal of radiation oncology, biology, physics.

[21]  Y. Yoshioka,et al.  Correlation between dosimetric parameters and late rectal and urinary toxicities in patients treated with high-dose-rate brachytherapy used as monotherapy for prostate cancer. , 2009, International journal of radiation oncology, biology, physics.

[22]  P. Hoskin,et al.  GEC/ESTRO recommendations on high dose rate afterloading brachytherapy for localised prostate cancer: an update. , 2013, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[23]  C. Rentsch,et al.  Toxicity and early treatment outcomes in low- and intermediate-risk prostate cancer managed by high-dose-rate brachytherapy as a monotherapy. , 2009, Brachytherapy.

[24]  H. Yamazaki,et al.  New implant technique for separation of the seminal vesicle and rectal mucosa for high-dose-rate prostate brachytherapy. , 2007, Brachytherapy.

[25]  New ambulatory implant technique of high-dose-rate interstitial brachytherapy for prostate cancer , 2006, Radiation Medicine.

[26]  Gerry Lowe,et al.  Justification for inter-fraction correction of catheter movement in fractionated high dose-rate brachytherapy treatment of prostate cancer. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[27]  P. Hoskin,et al.  High-dose-rate brachytherapy alone given as two or one fraction to patients for locally advanced prostate cancer: acute toxicity. , 2014, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[28]  J. Hannoun-levi,et al.  Prostate cancer boost using high-dose-rate brachytherapy: early toxicity analysis of 3 different fractionation schemes , 2013, Journal of contemporary brachytherapy.

[29]  D. Brizel,et al.  National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology , 2012 .

[30]  Dimos Baltas,et al.  High-dose-rate interstitial brachytherapy as monotherapy for clinically localized prostate cancer: treatment evolution and mature results. , 2013, International journal of radiation oncology, biology, physics.

[31]  Y. Yoshioka,et al.  Monotherapeutic high-dose-rate brachytherapy for prostate cancer: a dose reduction trial. , 2014, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[32]  P. Prada,et al.  High-dose-rate interstitial brachytherapy as monotherapy in one fraction and transperineal hyaluronic acid injection into the perirectal fat for the treatment of favorable stage prostate cancer: treatment description and preliminary results. , 2012, Brachytherapy.

[33]  T. Mate,et al.  High dose-rate afterloading 192Iridium prostate brachytherapy: feasibility report. , 1998, International journal of radiation oncology, biology, physics.

[34]  H. Yamazaki,et al.  Assessment of daily needle applicator displacement during high-dose-rate interstitial brachytherapy for prostate cancer using daily CT examinations. , 2012, Journal of radiation research.

[35]  P. Rzehak,et al.  Long-term outcome after elective irradiation of the pelvic lymphatics and local dose escalation using high-dose-rate brachytherapy for locally advanced prostate cancer. , 2002, International journal of radiation oncology, biology, physics.

[36]  K. Markou,et al.  National Comprehensive Cancer Network (NCCN) Head and Neck Cancers NCCN Clinical Practice Guidelines in Oncology . 2010. , 2011 .

[37]  D J Brenner,et al.  Fractionation and protraction for radiotherapy of prostate carcinoma. , 1999, International journal of radiation oncology, biology, physics.

[38]  Yasuo Yoshioka,et al.  Evaluation of anatomy-based dwell position and inverse optimization in high-dose-rate brachytherapy of prostate cancer: a dosimetric comparison to a conventional cylindrical dwell position, geometric optimization, and dose-point optimization. , 2005, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[39]  M. P. Van Gellekom,et al.  How low is the alpha/beta ratio for prostate cancer? , 2003, International journal of radiation oncology, biology, physics.

[40]  G. Gustafson,et al.  High-dose-rate monotherapy: safe and effective brachytherapy for patients with localized prostate cancer. , 2011, International journal of radiation oncology, biology, physics.

[41]  D. Baltas,et al.  3-D Conformal HDR Brachytherapy as Monotherapy for Localized Prostate Cancer , 2004, Strahlentherapie und Onkologie.

[42]  S J Damore,et al.  Needle displacement during HDR brachytherapy in the treatment of prostate cancer. , 2000, International journal of radiation oncology, biology, physics.

[43]  Y. Yoshioka,et al.  High-dose-rate brachytherapy without external beam irradiation for locally advanced prostate cancer. , 2006, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[44]  Andrew See,et al.  High-dose-rate brachytherapy as a monotherapy for favorable-risk prostate cancer: a Phase II trial. , 2012, International journal of radiation oncology, biology, physics.

[45]  Shafak Aluwini,et al.  HDR monotherapy for prostate cancer: a simulation study to determine the effect of catheter displacement on target coverage and normal tissue irradiation. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[46]  Rick Chappell,et al.  Is α/β for prostate tumors really low? , 2001 .

[47]  Y. Yoshioka,et al.  High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial. , 2000, International journal of radiation oncology, biology, physics.

[48]  Y. Yoshioka,et al.  Monotherapeutic high-dose-rate brachytherapy for prostate cancer: five-year results of an extreme hypofractionation regimen with 54 Gy in nine fractions. , 2011, International journal of radiation oncology, biology, physics.

[49]  R. Hansen,et al.  High dose brachytherapy as monotherapy for intermediate risk prostate cancer. , 2012, The Journal of urology.