Revised ASCO/CCO brachytherapy guidelines

The publication of the ASCENDE-RT clinical trial (discussed here) has led to a revision in the brachytherapy guidelines (available here) issued jointly by the American Society of Clinical Oncology (ASCO) and Cancer Care Ontario (CCO). The guidelines are for patients who choose radical therapy rather than active surveillance. … READ MORE …

Brachy boost: the gold standard for progression-free survival of high-risk prostate cancer

Several randomized clinical trials have established the superior oncological outcomes of the combination of external beam radiotherapy with a high-dose-rate brachytherapy boost (see this link). … READ MORE …

Is once ever enough (in prostate radiation therapy)?

When Jeff Demanes at the California Endocurietherapy Center, then in Oakland, CA, started doing high-dose-rate brachytherapy (HDR-BT) as a monotherapy (i.e., without any additional external beam therapy or hormone therapy), he arbitrarily chose a treatment schedule of 42 Gy delivered in six treatments or fractions. … READ MORE …

Brachytherapy alone is enough for favorable intermediate-risk patients

RTOG 0232 was a large clinical trial conducted to determine whether low-dose-rate brachytherapy (LDR-BT) alone was of equal benefit compared to external beam radiation therapy with a brachytherapy boost (EBRT + LDR-BT) in intermediate-risk patients. … READ MORE …

For very high-risk patients, EBRT + BT is superior to surgery or EBRT only

A retrospective analysis of oncological outcomes among modern-era patients with a Gleason score of 9 or 10 demonstrates a clear advantage to a combination of external beam radiation therapy (EBRT) with a brachytherapy (BT) boost to the prostate and short–term androgen deprivation therapy (ADT). … READ MORE …

Salvage low-dose-rate brachytherapy (LDRBT) after primary LDRBT failure

Although focal retreatment of the prostate using LDRBT has been used after failure of external beam radiation, there have been very few reports of salvage LDRBT after an initial treatment with LDRBT failed. … READ MORE …

Is there an optimal treatment schedule for high-dose-rate brachytherapy?

Protocols for high-dose-rate brachytherapy (HDR-BT) monotherapy vary. In recent years, practitioners have adopted various schedules for patient and physician convenience. … READ MORE …