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Updated: Jun 10, 2026

Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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[Which modality for prostate brachytherapy?].

A Bossi1

  • 1Département de radiothérapie, institut Gustave-Roussy, 39 rue Camille-Desmoulins, 94805 Villejuif, France. alberto.bossi@igr.fr

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|August 21, 2010
PubMed
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Brachytherapy using radioactive iodine-125 seeds or high-dose-rate (HDR) fractions offers effective prostate cancer treatment comparable to surgery. Ongoing research addresses technical aspects and defines disease control for improved patient outcomes.

Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Brachytherapy, including permanent iodine-125 seed implants and temporary high-dose-rate (HDR) fractions, is a primary treatment for prostate cancer.
  • Long-term data show permanent implants achieve efficacy and toxicity profiles comparable to surgery and external beam radiation for low-risk disease.
  • HDR implants serve as a dose escalation boost for intermediate to high-risk tumors.

Purpose of the Study:

  • To review current brachytherapy techniques for prostate cancer, including permanent seed implantation and HDR brachytherapy.
  • To identify areas needing clarification, such as expanded indications, technical variations (seed type, HDR protocols), and dosimetric challenges.
  • To emphasize the need for standardized definitions of biochemical disease control for both brachytherapy methods.

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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Main Methods:

  • Review of long-term outcome data from major centers for permanent iodine-125 seed brachytherapy.
  • Analysis of current practices and emerging research in HDR brachytherapy for prostate cancer.
  • Discussion of evolving applications, including salvage reirradiation and focal therapy approaches.

Main Results:

  • Permanent iodine-125 seed brachytherapy demonstrates long-term efficacy and acceptable toxicity for low-risk prostate cancer, matching surgery and external beam radiation.
  • HDR brachytherapy is utilized for dose escalation in higher-risk cancers.
  • Areas for further investigation include optimizing techniques, dosimetry, and defining biochemical control.

Conclusions:

  • Brachytherapy remains a cornerstone in prostate cancer management, with established roles for both permanent seeds and HDR fractions.
  • Future directions involve refining techniques for new indications like salvage therapy and focal treatments, alongside standardizing outcome measures.
  • Continued research is essential to optimize brachytherapy protocols and ensure precise dose delivery for improved cancer control and reduced toxicity.