Combining theoretical potential and advanced technology in high-dose rate brachytherapy boost therapy for prostate cancer

• Published in: Expert review of medical devices Vol. 10; no. 6; pp. 751 - 763
• Main Authors: Zaorsky, Nicholas G, Den, Robert B, Doyle, Laura A, Dicker, Adam P, Hurwitz, Mark D
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare 01.11.2013; Taylor & Francis
• Subjects: Beams (radiation); Biochemistry; brachytherapy; Brachytherapy - adverse effects; Brachytherapy - methods; Cancer; Clinical Trials as Topic; Humans; Male; Patients; Prostate; prostate cancer; Prostatic Neoplasms - radiotherapy; quality of life; Radiation therapy; Radiotherapy Dosage; technology; Tempering; Toxicity; Treatment Outcome
• ISSN: 1743-4440; 1745-2422
• DOI: 10.1586/17434440.2013.841347

External beam radiation therapy (EBRT) combined with brachytherapy (BT) is an attractive treatment option for select patients with clinically localized prostate cancer. Either low- or high-dose rate BT may be combined with EBRT ('LDR-BT boost,' 'HDR-BT boost,' respectively). HDR-BT boost has potential theoretical benefits over LDR-BT boost or external beam radiation therapy monotherapy in terms of radiobiology, radiophysics and patient convenience. Based on prospective studies in this review, freedom from biochemical failure (FFBF) rates at 5 years for low-, intermediate- and high-risk patients have generally been 85-100%, 68-97%, 63-85%, respectively; late Radiotherapy and Oncology Group Grades 3 and 4 genitourinary and gastrointestinal toxicities are seen in <8% of patients. HDR-BT boost is now a relatively well-established treatment modality for certain intermediate-risk and high-risk prostate cancer patients, though limitations exist in drawing conclusions from the currently published studies.