Skip to main content
SpringerLink
Log in

High-Dose-Rate Brachytherapy for the Treatment of Low-, Intermediate-, and High-Risk Prostate Cancer

  • Chapter
  • First Online:
Book cover Robotic Radiosurgery. Treating Prostate Cancer and Related Genitourinary Applications

Abstract

Brachytherapy is a type of radiation therapy that allows for the delivery of highly conformal radiation for prostate cancer in the setting of monotherapy for low-risk disease and as a boost for intermediate- to high-risk patients. There are two types of brachytherapy, high-dose-rate (HDR) and low-dose-rate (LDR) brachytherapy, both of which may be used as monotherapy or boost. HDR brachytherapy may offer advantages over LDR including improved accuracy of treatment, toxicities, and radiation safety issues. Brachytherapy has been shown to have similar biochemical control (BC) compared to radical prostatectomy (RP) or external-beam radiotherapy (EBRT) and therefore is a good therapeutic option for appropriately selected patients. We have reviewed the results of 474 patients treated with HDR monotherapy at William Beaumont Hospital, and the results show that BC rates are similar to that of RP or EBRT with low rates of high-grade chronic genitourinary or gastrointestinal toxicities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mettlin CJ, Murphy GP, McDonald CJ et al (1999) The National Cancer Data base Report on increased use of brachytherapy for the treatment of patients with prostate carcinoma in the U.S. Cancer 86:1877–1882

    Article  PubMed  CAS  Google Scholar 

  2. Lee WR, Moughan J, Owen JB et al (2003) The 1999 patterns of care study of radiotherapy in localized prostate carcinoma: a comprehensive survey of prostate brachytherapy in the United States. Cancer 98:1987–1994

    Article  PubMed  Google Scholar 

  3. Mohler J, Bahnson RR, Boston B et al (2010) NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw 8:162–200

    PubMed  CAS  Google Scholar 

  4. Martinez AA, Gonzalez JA, Chung AK et al (2000) A comparison of external beam radiation therapy versus radical prostatectomy for patients with low risk prostate carcinoma diagnosed, staged, and treated at a single institution. Cancer 88:425–432

    Article  PubMed  CAS  Google Scholar 

  5. Kupelian P, Katcher J, Levin H et al (1997) External beam radiotherapy versus radical prostatectomy for clinical stage T1–2 prostate cancer: therapeutic implications of stratification by pretreatment PSA levels and biopsy Gleason scores. Cancer J Sci Am 3:78–87

    PubMed  CAS  Google Scholar 

  6. Blasko JC, Grimm PD, Sylvester JE et al (2000) Palladium-103 brachytherapy for prostate carcinoma. Int J Radiat Oncol Biol Phys 46:839–850

    Article  PubMed  CAS  Google Scholar 

  7. D’Amico AV, Whittington R, Malkowicz SB et al (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280:969–974

    Article  PubMed  Google Scholar 

  8. Eade TN, Horwitz EM, Ruth K et al (2008) A comparison of acute and chronic toxicity for men with low-risk prostate cancer treated with intensity-modulated radiation therapy or (125) I permanent implant. Int J Radiat Oncol Biol Phys 71:338–345

    Article  PubMed  Google Scholar 

  9. Kupelian PA, Potters L, Khuntia D et al (2004) Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy  >  or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int J Radiat Oncol Biol Phys 58:25–33

    Article  PubMed  Google Scholar 

  10. Stock RG, Stone NN, Tabert A et al (1998) A dose-response study for I-125 prostate implants. Int J Radiat Oncol Biol Phys 41:101–108

    Article  PubMed  CAS  Google Scholar 

  11. Wallner K, Merrick G, True L et al (2002) I-125 versus Pd-103 for low-risk prostate cancer: morbidity outcomes from a prospective randomized multicenter trial. Cancer J 8:67–73

    Article  PubMed  Google Scholar 

  12. Demanes DJ, Rodriguez RR, Altieri GA (2000) High dose rate prostate brachytherapy: the California Endocurietherapy (CET) method. Radiother Oncol 57:289–296

    Article  PubMed  CAS  Google Scholar 

  13. Martinez AA, Pataki I, Edmundson G et al (2001) 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. Int J Radiat Oncol Biol Phys 49:61–69

    Article  PubMed  CAS  Google Scholar 

  14. Yoshioka Y, Nose T, Yoshida K et al (2000) High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial. Int J Radiat Oncol Biol Phys 48:675–681

    Article  PubMed  CAS  Google Scholar 

  15. Grills IS, Martinez AA, Hollander M et al (2004) High dose rate brachytherapy as prostate cancer monotherapy reduces toxicity compared to low dose rate palladium seeds. J Urol 171:1098–1104

    Article  PubMed  Google Scholar 

  16. Martinez AA, Demanes J, Vargas C et al (2010) High-dose-rate prostate brachytherapy: an excellent accelerated-hypofractionated treatment for favorable prostate cancer. Am J Clin Oncol 33:481–488

    Article  PubMed  Google Scholar 

  17. Oefelein MG, Smith ND, Grayhack JT et al (1997) Long-term results of radical retropubic prostatectomy in men with high grade carcinoma of the prostate. J Urol 158:1460–1465

    Article  PubMed  CAS  Google Scholar 

  18. Hanks GE, Diamond JJ, Krall JM et al (1987) A ten year follow-up of 682 patients treated for prostate cancer with radiation therapy in the United States. Int J Radiat Oncol Biol Phys 13:499–505

    Article  PubMed  CAS  Google Scholar 

  19. Pilepich MV, Caplan R, Byhardt RW et al (1997) Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85–31. J Clin Oncol 15:1013–1021

    PubMed  CAS  Google Scholar 

  20. Bolla M, Van Tienhoven G, Warde P et al (2010) External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol 11:1066–1073

    Article  PubMed  CAS  Google Scholar 

  21. Forman JD, Duclos M, Sharma R et al (1996) Conformal mixed neutron and photon irradiation in localized and locally advanced prostate cancer: preliminary estimates of the therapeutic ratio. Int J Radiat Oncol Biol Phys 35:259–266

    Article  PubMed  CAS  Google Scholar 

  22. Shipley WU, Verhey LJ, Munzenrider JE et al (1995) Advanced prostate cancer: the results of a randomized comparative trial of high dose irradiation boosting with conformal protons compared with conventional dose irradiation using photons alone. Int J Radiat Oncol Biol Phys 32:3–12

    Article  PubMed  CAS  Google Scholar 

  23. Zelefsky MJ, Leibel SA, Gaudin PB et al (1998) Dose escalation with three-dimensional conformal radiation therapy affects the outcome in prostate cancer. Int J Radiat Oncol Biol Phys 41:491–500

    Article  PubMed  CAS  Google Scholar 

  24. Hanks GE, Lee WR, Hanlon AL et al (1996) Conformal technique dose escalation for prostate cancer: biochemical evidence of improved cancer control with higher doses in patients with pretreatment prostate-specific antigen  >  or  =  10 NG/ML. Int J Radiat Oncol Biol Phys 35:861–868

    Article  PubMed  CAS  Google Scholar 

  25. Martinez A, Gonzalez J, Spencer W et al (2003) Conformal high dose rate brachytherapy improves biochemical control and cause specific survival in patients with prostate cancer and poor prognostic factors. J Urol 169:974–979

    Article  PubMed  Google Scholar 

  26. Galalae RM, Martinez A, Mate T et al (2004) Long-term outcome by risk factors using conformal high-dose-rate brachytherapy (HDR-BT) boost with or without neoadjuvant androgen suppression for localized prostate cancer. Int J Radiat Oncol Biol Phys 58:1048–1055

    Article  PubMed  Google Scholar 

  27. Edmundson GK, Rizzo NR, Teahan M et al (1993) Concurrent treatment planning for outpatient high dose rate prostate template implants. Int J Radiat Oncol Biol Phys 27:1215–1223

    Article  PubMed  CAS  Google Scholar 

  28. Edmundson GK, Yan D, Martinez AA (1995) Intraoperative optimization of needle placement and dwell times for conformal prostate brachytherapy. Int J Radiat Oncol Biol Phys 33:1257–1263

    Article  PubMed  CAS  Google Scholar 

  29. Martinez AA, Demanes DJ, Galalae R et al (2005) Lack of benefit from a short course of androgen deprivation for unfavorable prostate cancer patients treated with an accelerated hypofractionated regime. Int J Radiat Oncol Biol Phys 62:1322–1331

    Article  PubMed  Google Scholar 

  30. Stock RG, Cesaretti JA, Hall SJ et al (2009) Outcomes for patients with high-grade prostate cancer treated with a combination of brachytherapy, external beam radiotherapy and hormonal therapy. BJU Int 104:1631–1636

    Article  PubMed  Google Scholar 

  31. Bastian PJ, Gonzalgo ML, Aronson WJ et al (2006) Clinical and pathologic outcome after radical prostatectomy for prostate cancer patients with a preoperative Gleason sum of 8 to 10. Cancer 107:1265–1272

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, USA

    Mackenzie McGee M.D., Mihai Ghilezan M.D. & Alvaro Martinez M.D.

Authors
  1. Mackenzie McGee M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mihai Ghilezan M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alvaro Martinez M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Dept. Urology, Center for Urologic Oncology &, University Hospitals Case Medical Center, Euclid Avenue 11100, Cleveland, 44106, Ohio, USA

    Lee E. Ponsky

  2. Radiosurgery Medical Group, Inc., San Diego Cyberknife Center, Ruffin Rd. 5395, San Diego, 92123, California, USA

    Donald B. Fuller

  3. Medical Director, Radiation Oncology, Swedish Cancer Institute at Northwest Ho, 1560 North 115th Street G16, Seattle, 98133, Washington, USA

    Robert M. Meier

  4. Director, Physics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, 19111-2497, Pennsylvania, USA

    Charlie Ma

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

McGee, M., Ghilezan, M., Martinez, A. (2012). High-Dose-Rate Brachytherapy for the Treatment of Low-, Intermediate-, and High-Risk Prostate Cancer. In: Ponsky, L., Fuller, D., Meier, R., Ma, C. (eds) Robotic Radiosurgery. Treating Prostate Cancer and Related Genitourinary Applications. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11495-3_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-11495-3_10

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-11494-6

  • Online ISBN: 978-3-642-11495-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation