Interstitial radiotherapy has been used for the treatment of prostatic cancer since the early 1900s. In 1917 Hugh Young reported a series of patients treated with radium needles implanted transperineally, transrectally, and transurethrally (Young and Fronz 1917). Even with the primitive techniques available, several long-term disease-free survivors were reported (Barringer 1942). With the advent of megavoltage external beam irradiation techniques in the 1950s, Bagshaw clearly demonstrated that radiotherapy is effective in controlling prostatic cancer, previously considered “radioresistant” (Ray and Bagshaw 1975). But with time it became clear that doses in the upper range of clinical tolerance (7000 rad) were necessary to control the local tumor in most patients and that such doses led to a high complication rate when external beam therapy was used alone. Basing their work upon the experience of Flocks et al. (1959), a new generation of urologists and radiotherapists initiated the contemporary experience with interstitial radiotherapy (“brachytherapy”) in an effort to deliver larger doses of irradiation to the prostate with fewer complications. Modern techniques of brachytherapy include implantation of radioactive seeds of gold, iodine, or iridium, with or without external beam irradiation. The major conceptual limitation of brachytherapy, however, remains the problem of a “geographic miss”—failure to irradiate all areas of the tumor sufficiently because of uneven seed placement.
KeywordsToxicity Adenocarcinoma Iodine Radium Oncol
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