Brachytherapy and local control

Locoregional control of primary tumor is fundamental to cure since only in one third of patients the onset of distant metastases is the major cause of therapeutic failure. Thus recently, all therapeutic approaches aimed at the enhancement of locoregional control have been considered with growing interest. More particularly, brachytherapy alone or in combined modality therapy as an important option in the local treatment of various malignant tumors, has been widely used; this being related to the now available information on dose-rate, remote after-loading procedures, the new, safe and handy radionuclides and computerized dosimetry systems which allow a more accurate and rapid dose calculation. These advances have led to a wider application of brachytherapy. Together with the classical indications for head and neck and cervical tumors, brachytherapy plays now a well-established role in the treatment of breast, brain, gastrointestinal, genitourinary, soft tissue lung and eye tumors.