High-Dose-Rate Brachytherapy in the Treatment of Clinically Localized Prostate Cancer

Part of the Medical Radiology book series (MEDRAD)


Recent radiobiological findings support that the α/β-ratio for prostate adenocarcinoma is less than that for the normal organs that ordinarily constrain the delivery of radiation therapy. As a result, hypofractionation has attracted greatly renewed interest and during the last 15 years a special interest in the implementation of brachytherapy (BRT) has evolved for the treatment of localized prostate cancer. Especially high-dose-rate (HDR) BRT is recently gaining momentum as an alternative to low-dose-rate and technological improvements in image guidance and real-time treatment planning place this interventional radiooncological modality at the forefront of innovation in radiotherapy. This chapter will explore the rationale for HDR BRT as a highly conformal method of dose delivery and safe biologic dose escalation through hypofractionation. Oncological outcome data and toxicity profiles will be discussed for the combination with external beam radiotherapy and in the monotherapy setting. In addition to clinical results of primary and salvage treatment protocols, dose-fractionation schedules and normal tissue dose constraints used by various centres are also reported.


Gleason Score Androgen Deprivation Therapy Urethral Stricture Biochemical Control Late Grade 


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© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Sana Klinikum Offenbach StrahlenklinikOffenbachGermany

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