Prostate Brachytherapy

Prostate brachytherapy has been practiced for nearly 100 years in various forms. However, technological advances over the past 20 years in imaging, computing, and devices have propelled this technique into the mainstream of prostate cancer treatments. A discussion of radiobiology principles is important to the understanding of modern brachytherapy technique. For low risk tumors, brachytherapy may be administered as monotherapy. For high risk tumors combination therapy with external beam therapy is indicated. Androgen ablation therapy is used for hormonal downsizing or for select high risk tumors. Diseases free survival appears similar to that seen with other definitive therapies for clinically localized prostate cancer. The short term morbidity of the procedure includes significant obstructive and irritative voiding symptoms. Future brachytherapy goals are discussed.