[What is new in brachytherapy?]

The brachytherapy was used as of the discovery of the radioactivity and became a modern method of conformational irradiation using high technology. Every year, 8-10,000 treatments are delivered, which represents 5% of the total number of irradiations in France. Its revival comes from its increasing use in the treatment of localised cancers of the prostate of favourable prognosis, because of its effectiveness comparable with that of the surgery or the external radiotherapy, its very good immediate tolerance and its better preservation of the erectile function. In 2005, more of 1000 patients were treated in France, number that should quickly rise. The gynecological brachytherapy remains essential in the treatment of the invasive cancers of the uterine cervix. It profits of the progress of the imagery and in the optimisation of the calculation of the dose distribution allowing the optimisation of the irradiation by means of stepping source afterloaders (pulsed brachytherapy). The brachytherapy in head and neck keeps its indications, especially in the exclusive or postoperative irradiation of the cancers of the oral cavity or of the oropharynx. In the treatment of the breast cancer, a new position for the modern brachytherapy should be occur with the concepts of brachytherapy boost. Lastly, many precise indications are always of topicality. Thus, the brachytherapy by permanent implants, at low dose rate, high dose rate or pulsed dose rate, associated to the tools of imagery, of optimisation and technologies of stepping source afterloaders is competing or complementary with new 3D or 4D techniques of three or four dimensional irradiation.