Role of interstitial brachytherapy in the treatment of malignant disease

Interstitial brachytherapy was first applied using radium needles, with minimum protection of physicians and nurses. Modern techniques involve the use of radionuclide (192)Ir as the source used in computer-controlled remote afterloading machines, which can deliver a high dose rate (HDR). Treatment planning is also undertaken with the use of computers and anatomical cross-section images using CT, ultrasound and MRI. This review presents these modern techniques for tumors of a series of body sites: prostate, head and neck, breast, bladder, brain, and for soft-tissue sarcomas. Low dose rate (LDR) interstitial brachytherapy techniques are also included in this review since in some body sites there is a choice between HDR and LDR.