High and low dose-rate brachytherapy for cervical carcinoma

For the brachytherapy component of the radiation treatment of cervical carcinoma, high dose rate (HDR) is slowly replacing conventional low dose rate (LDR) due primarily to radiation safety and other physical benefits attributed to the HDR modality. Many radiation oncologists are reluctant to make this change because of perceived radiobiological disadvantages of HDR. However, in clinical practice HDR appears to be as effective as LDR but with a lower risk of late complications, as demonstrated by one randomized clinical trial and two comprehensive literature and practice surveys. The reason for this appears to be that the radiobiological disadvantages of HDR are outweighed by the physical advantages.