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GEC-ESTRO ACROP prostate brachytherapy guidelines.

Ann Henry1, Bradley R Pieters2, Frank André Siebert3

  • 1St James University Hospital, Leeds, UK.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|January 9, 2022
PubMed
Summary
This summary is machine-generated.

Prostate brachytherapy, using Low Dose Rate (LDR) or High Dose Rate (HDR) permanent or temporary implants, offers improved PSA control for non-metastatic prostate cancer. This technique allows for precise radiation delivery, sparing nearby organs.

Keywords:
BrachytherapyConsensus guidelinesHigh Dose RateLow Dose RateProstate cancer

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Medical Physics

Background:

  • Prostate brachytherapy is an established and evolving treatment for non-metastatic prostate cancer.
  • It involves permanent (Low Dose Rate - LDR) or temporary (High Dose Rate - HDR) radioactive source implantation.
  • Previous guidelines addressed LDR and HDR separately, necessitating updated, combined recommendations.

Purpose of the Study:

  • To provide updated, evidence-based guidance for both Low Dose Rate (LDR) and High Dose Rate (HDR) prostate brachytherapy.
  • To consolidate recommendations for permanent and temporary prostate brachytherapy techniques.
  • To offer guidance based on the Oxford Centre for Evidence-based Medicine levels of evidence.

Main Methods:

  • Systematic review and analysis of randomized trials.
  • Evidence-based guideline development following Oxford Centre for Evidence-based Medicine criteria.
  • Consolidation of recommendations for LDR and HDR prostate brachytherapy.

Main Results:

  • Prostate brachytherapy allows for safe radiation dose escalation compared to external beam radiotherapy alone.
  • Greater conformity of radiation dose around the prostate spares surrounding organs like the rectum, bladder, and penile bulb.
  • Systematic reviews and trials show improved Prostate-Specific Antigen (PSA) control with brachytherapy boost compared to external beam radiotherapy alone.

Conclusions:

  • Prostate brachytherapy, encompassing both LDR and HDR techniques, is a valuable treatment option for non-metastatic prostate cancer.
  • The technique offers improved treatment conformity and reduced toxicity.
  • Evidence supports its use for enhanced PSA control when used as a boost treatment.