Permanent prostate brachytherapy in men with clinically localised prostate cancer

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Permanent prostate brachytherapy demonstrates excellent biochemical control for localized prostate cancer.
• Long-term data confirm compatibility with external beam irradiation or radical prostatectomy.
• Significant variability exists in treatment protocols and techniques across centers.

Purpose of the Study:

• To review current prostate brachytherapy techniques and their outcomes.
• To highlight the importance of post-implant dosimetry for predicting treatment success.
• To discuss challenges and advancements in prostate brachytherapy planning and dosimetry.

Main Methods:

• Review of existing literature and 10-year outcome data for permanent prostate brachytherapy.
• Analysis of computed tomography (CT)-based criteria for implant quality assessment.
• Discussion of emerging treatment planning technologies for dosimetry improvement.

Main Results:

• Permanent prostate brachytherapy achieves excellent long-term biochemical control.
• Post-implant dosimetry appears more significant for outcome prediction than adjuvant therapies.
• CT-based criteria show promise for evaluating implant quality and delivered dose.

Conclusions:

• Standardization of prostate brachytherapy protocols is needed.
• Accurate post-implant dosimetry is essential and should be a requirement.
• Advancements in treatment planning systems can improve implant procedures and dosimetry, overcoming imaging limitations.