Skip to main content
SpringerLink
Log in

Current status and perspectives of brachytherapy for prostate cancer

  • Review Article
  • Published:
International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Permanent implant brachytherapy (PIB) for prostate cancer in a modern style was introduced in the 1980s. With the excellent outcome, the method prevailed rapidly in the United States in the 1990s, and it has become a standard treatment option at least for low-risk prostate cancer today. In Japan, PIB using 125I free seeds was started in 2003, and it is being rapidly accepted. About 90 institutions in Japan have already started PIB, and about 10 000 patients have received this treatment during these 5 years. The outcome data for Japanese men should be established, and the efficacy of the combined use of external beam radiation therapy (EBRT) and hormone therapy should be examined. High-dose-rate (HDR) brachytherapy, which has many advantages over PIB, was started in the 1980s, firstly as a boost combined with EBRT, in Europe and the United States. In Japan, combined HDR brachytherapy and EBRT therapy was started in 1994. As for monotherapeutic HDR brachytherapy, the first series in the world was initiated in Osaka, Japan, in 1995. HDR brachytherapy, both as monotherapy and as combined therapy with EBRT, is yielding promising outcomes, and the study of these modalities should be continued. Mutual understanding and cooperation among urologists, radiation oncologists, and medical physicists is essential to enhance brachytherapy for prostate cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bell AG (1903) The uses of radium. Am Med 6:261

    Google Scholar 

  2. Young HH (1917) The use of radium in cancer of the prostate and bladder: a presentation of new instruments and new methods of use. JAMA 68:1174–1177

    Google Scholar 

  3. Flocks R, Kerr H, Elkins H, et al. (1959) The treatment of carcinoma of the prostate by interstitial radiation with radioactive gold: a follow-up report. J Urol 71:628–633

    Google Scholar 

  4. Whitmore WF, Hilaris BS, Grabstold H (1972) Retropubic implantation of iodine-125 in the treatment of prostatic cancer. J Urol 108:918–920

    PubMed  Google Scholar 

  5. Zelefsky MJ, Whitmore WF (1997) Long-term results of retropubic permanent I-125 implantation of the prostate for clinically localized prostate cancer. J Urol 158:23–29

    Article  PubMed  CAS  Google Scholar 

  6. Holm HH, Juul N, Pedersen JF, et al. (1983) Transperineal 125I seed implantation in prostatic cancer guided by transrectal ultrasonography. J Urol 130:283–286

    PubMed  CAS  Google Scholar 

  7. Ragde H, Blasko JC, Grimm PD, et al. (1997) Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma. Cancer 80:442–453

    Article  PubMed  CAS  Google Scholar 

  8. Galalae RM, Kovacs G, Schultze J, et al. (2002) Long-term outcome after elective irradiation of the pelvic lymphatics and local dose escalation using high-dose-rate brachytherapy for locally advanced prostate cancer. Int J Radiat Oncol Biol Phys 52:81–90

    PubMed  Google Scholar 

  9. Borghede G, Hedelin H, Holmang S, et al. (1997) Combined treatment with temporary short-term high dose rate iridium-192 brachytherapy and external beam radiotherapy for irradiation of localized prostatic carcinoma. Radiother Oncol 44:237–244

    Article  PubMed  CAS  Google Scholar 

  10. Mate TP, Gottesman JE, Hatton J, et al. (1998) High dose-rate afterloading Ir-192 prostate brachytherapy: feasibility report. Int J Radiat Oncol Biol Phys 41:525–533

    Article  PubMed  CAS  Google Scholar 

  11. Yoshioka Y, Nose T, Yoshida K, et al. (2000) High-dose-rate interstitial brachytherapy as a monotherapy for localized prostate cancer: treatment description and preliminary results of a phase I/II clinical trial. Int J Radiat Oncol Biol Phys 48:675–681

    PubMed  CAS  Google Scholar 

  12. Nath R, Anderson LL, Luxton G, et al. (1995) Dosimetry of interstitial brachytherapy sources: recommendations of the AAPM Radiation Therapy Committee Task Group No. 43. Med Phys 22: 209–234

    Article  PubMed  CAS  Google Scholar 

  13. Nath R, Anderson LL, Meli JA, et al. (1997) Code of practice for brachytherapy physics: Report of the AAPM Radiation Therapy Committee Task Group No. 56. Med Phys 24:1557–1598

    Article  PubMed  CAS  Google Scholar 

  14. Takahashi Y, Ito A, Sumida I, et al. (2006) Dosimetric consideration of individual 125I source strength measurement and a largescale comparison of that measured with a nominal value in permanent prostate implant brachytherapy. Radiat Med 24:675–679

    Article  PubMed  Google Scholar 

  15. Saito S, Nagata H, Kosugi M, et al. (2007) Brachytherapy with permanent seed implantation. Int J Clin Oncol 12:395–407

    Article  PubMed  Google Scholar 

  16. Cesaretti JA, Stone NN, Skouteris VM, et al. (2007) Brachytherapy for the treatment of prostate cancer. Cancer J 13:302–312

    Article  PubMed  Google Scholar 

  17. Stone NN, Stock RG, Unger P (2005) Intermediate term biochemical-free progression and local control following 125 iodine brachytherapy for prostate cancer. J Urol 173:803–807

    Article  PubMed  Google Scholar 

  18. Potters L, Morgenstern C, Calugaru E, et al. (2005) Twelve-year outcomes following permanent prostate brachytherapy in patients with clinically localized prostate cancer. J Urol 173:1562–1566

    Article  PubMed  Google Scholar 

  19. Ragde H, Korb LJ, Elgamal AA, et al. (2000) Modern prostate brachytherapy. Prostate specific antigen results in 219 patients with up to 12 years of observed follow-up. Cancer 89:135–141

    Article  PubMed  CAS  Google Scholar 

  20. Zelefsky MJ, Yamada Y, Cohen GN, et al. (2007) Five-year outcome of intraoperative conformal permanent I-125 interstitial implantation for patients with clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 67:65–70

    PubMed  Google Scholar 

  21. Battermann JJ, Boon TA, Moerland MA (2004) Results of permanent prostate brachytherapy, 13 years of experience at a single institution. Radiother Oncol 71:23–28

    Article  PubMed  Google Scholar 

  22. Beyer DC, Brachman DG (2000) Failure free survival following brachytherapy alone for prostate cancer: comparison with external beam radiotherapy. Radiother Oncol 57:263–267

    Article  PubMed  CAS  Google Scholar 

  23. Critz FA, Levinson K (2004) Ten-year disease-free survival rates after simultaneous irradiation for prostate cancer with a focus on calculation methodology. J Urol 172:2232–2238

    Article  PubMed  Google Scholar 

  24. Sylvester JE, Grimm PD, Blasko JC, et al. (2007) Fifteen-year biochemical relapse free survival in clinical stage T1-T3 prostate cancer following combined external beam radiotherapy and brachytherapy; Seattle experience. Int J Radiat Oncol Biol Phys 67:57–64

    PubMed  Google Scholar 

  25. Dattoli M, Wallner K, True L, et al. (2007) Long-term outcomes after treatment with brachytherapy and supplemental conformal radiation for prostate cancer patients having intermediate and high-risk features. Cancer 110:551–555

    Article  PubMed  Google Scholar 

  26. Fuller DB, Vicini FA, Kestin LL, et al. (1999) Prostatectomy, external beam radiation therapy, or brachytherapy for localized prostate cancer. JAMA 281:1583–1586

    Article  PubMed  CAS  Google Scholar 

  27. Kwok Y, DiBiase SJ, Amin PP, et al. (2002) Risk group stratification in patients undergoing permanent 125I prostate brachytherapy as monotherapy. Int J Radiat Oncol Biol Phys 53:588–594

    PubMed  Google Scholar 

  28. Critz FA, Levinson AK, Williams WH, et al. (1998) Simultaneous radiotherapy for prostate cancer: 125I prostate implant followed by external-beam radiation. Cancer J Sci Am 4:359–363

    PubMed  CAS  Google Scholar 

  29. Ragde H, Elgamal AA, Snow PB, et al. (1998) Ten-year disease free survival after transperineal sonography-guided iodine-125 brachytherapy with or without 45-gray external beam irradiation in the treatment of patients with clinically localized, low to high Gleason grade prostate carcinoma. Cancer 83:989–1001

    Article  PubMed  CAS  Google Scholar 

  30. Albert M, Tempany CM, Schultz D, et al. (2003) Late genitourinary and gastrointestinal toxicity after magnetic resonance imageguided prostate brachytherapy with or without neoadjuvant external beam radiation therapy. Cancer 98:949–954

    Article  PubMed  Google Scholar 

  31. Sarosdy MF (2004) Urinary and rectal complications of contemporary permanent transperineal brachytherapy for prostate carcinoma with or without external beam radiation therapy. Cancer 101:754–760

    Article  PubMed  Google Scholar 

  32. Ghaly M, Wallner K, Merrick G, et al. (2003) The effect of supplemental beam radiation on prostate brachytherapy-related morbidity: morbidity outcomes from two prospective randomized multicenter trials. Int J Radiat Oncol Biol Phys 55:1288–1293

    PubMed  Google Scholar 

  33. Lee WR, DeSilvio M, Lawton C, et al. (2006) A phase II study of external beam radiotherapy combined with permanent source brachytherapy for intermediate-risk, clinically localized adenocarcinoma of the prostate: preliminary results of RTOG P-0019. Int J Radiat Oncol Biol Phys 64:804–809

    PubMed  Google Scholar 

  34. Nag S, Beyer D, Friedland J, et al. (1999) American Brachytherapy Society (ABS) recommendations for transperineal permanent brachytherapy of prostate cancer. Int J Radiat Oncol Biol Phys 44:789–799

    Article  PubMed  CAS  Google Scholar 

  35. Ash D, Flynn A, Battermann J, et al. (2000) ESTRO/EAU/EORTC recommendations on permanent seed implantation for localized prostate cancer. Radiother Oncol 57:315–321

    Article  PubMed  CAS  Google Scholar 

  36. Yoshioka Y, Nose T, Yoshida K, et al. (2003) High-dose-rate brachytherapy as monotherapy for localized prostate cancer: a retrospective analysis with special focus on tolerance and chronic toxicity. Int J Radiat Oncol Biol Phys 56:213–220

    PubMed  Google Scholar 

  37. Oh RJ, Yoshioka Y, Tanaka E, et al. (2006) High-dose-rate brachytherapy combined with long-term hormonal therapy for high-risk prostate cancer: results of a retrospective analysis. Radiat Med 24:58–64

    Article  PubMed  CAS  Google Scholar 

  38. Yoshioka Y, Konishi K, Oh RJ, et al. (2006) High-dose-rate brachytherapy without external beam irradiation for locally advanced prostate cancer. Radiother Oncol 80:62–68

    Article  PubMed  Google Scholar 

  39. Yoshida K, Nose T, Shiomi H, et al. (2006) New ambulatory implant technique of high-dose-rate interstitial brachytherapy for prostate cancer. Radiat Med 24:595–599

    Article  PubMed  Google Scholar 

  40. Yoshida K, Kuroda S, Yoshida M, et al. (2007) New implant technique for separation of the seminal vesicle and rectal mucosa for high-dose-rate prostate brachytherapy. Brachytherapy 6:180–186

    Article  PubMed  Google Scholar 

  41. Martinez A, Pataki I, Edmundson G, et al. (2001) Phase II prospective study of the use of conformal high-dose-rate brachytherapy as monotherapy for the treatment of favorable stage prostate cancer: a feasibility report. Int J Radiat Oncol Biol Phys 49:61–69

    PubMed  CAS  Google Scholar 

  42. Martin T, Baltas D, Kurek R, et al. (2004) 3-D conformal HDR brachytherapy as monotherapy for localized prostate cancer. A pilot study. Strahlenther Onkol 180:225–232

    Article  Google Scholar 

  43. Corner C, Rojas AM, Bryant L, et al. (2008) A phase II study of high-dose-rate afterloading brachytherapy as monotherapy for the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys 72:441–446

    PubMed  Google Scholar 

  44. Aström L, Pedersen D, Mercke C, et al. (2005) Long-term outcome of high dose rate brachytherapy in radiotherapy of localised prostate cancer. Radiother Oncol 74:157–161

    Article  PubMed  Google Scholar 

  45. Demanes DJ, Rodriguez RR, Schour L, et al. (2005) High-doserate intensity-modulated brachytherapy with external beam radiotherapy for prostate cancer: California endocurietherapy’s 10-year results. Int J Radiat Oncol Biol Phys 61:1306–1316

    PubMed  Google Scholar 

  46. Martinez A, Gonzalez J, Stromberg J, et al. (1995) Conformal prostate brachytherapy: initial experience of a phase I/II doseescalating trial. Int J Radiat Oncol Biol Phys 33:1019–1027

    PubMed  CAS  Google Scholar 

  47. Vargas CE, Martinez AA, Boike TP, et al. (2006) High-dose irradiation for prostate cancer via a high-dose-rate brachytherapy boost: results of a phase I to II study. Int J Radiat Oncol Biol Phys 66:416–423

    PubMed  Google Scholar 

  48. Dinges S, Deger S, Koswig S, et al. (1998) High-dose rate interstitial with external beam irradiation for localized prostate cancer — results of a prospective trial. Radiother Oncol 48:197–202

    Article  PubMed  CAS  Google Scholar 

  49. Deger S, Boehmer D, Roigas J, et al. (2005) High dose rate (HDR) brachytherapy with conformal radiation therapy for localized prostate cancer. Eur Urol 47:441–448

    Article  PubMed  Google Scholar 

  50. Hiratsuka J, Jo Y, Yoshida K, et al. (2004) Clinical results of combined treatment conformal high-dose-rate iridium-192 brachytherapy and external beam radiotherapy using staging lymphadenectomy for localized prostate cancer. Int J Radiat Oncol Biol Phys 59:684–690

    PubMed  Google Scholar 

  51. Jo Y, Hiratsuka J, Fujii T, et al. (2004) High-dose-rate iridium-192 afterloading therapy combined with external beam radiotherapy for T1c-T3bN0M0 prostate cancer. Urology 64:556–560

    Article  PubMed  Google Scholar 

  52. Shigehara K, Mizokami A, Komatsu K, et al. (2006) Four year clinical statistics of iridium-192 high dose rate brachytherapy. Int J Urol 13:116–121

    Article  PubMed  Google Scholar 

  53. Egawa S, Shimura S, Irie A, et al. (2001) Toxicity and healthrelated quality of life during and after high dose rate brachytherapy followed by external beam radiotherapy for prostate cancer. Jpn J Clin Oncol 31:541–547

    Article  PubMed  CAS  Google Scholar 

  54. Sato M, Mori T, Shirai S, et al. (2008) High-dose-rate brachytherapy of a single implant with two fractions combined with external beam radiotherapy for hormone-naive prostate cancer. Int J Radiat Oncol Biol Phys 72:1002–1009

    PubMed  Google Scholar 

  55. Akimoto T, Ito K, Saitoh J, et al. (2005) Acute genitourinary toxicity after high-dose-rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity. Int J Radiat Oncol Biol Phys 63:463–471

    PubMed  Google Scholar 

  56. Akimoto T, Katoh H, Noda SE, et al. (2005) Acute genitourinary toxicity after high dose rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: second analysis to determine the correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity. Int J Radiat Oncol Biol Phys 63:472–478

    PubMed  Google Scholar 

  57. Akimoto T, Katoh H, Kitamoto Y, et al. (2006) Anatomybased inverse optimization in high-dose-rate brachytherapy combined with hypofractionated external beam radiotherapy for localized prostate cancer: comparison of incidence of acute genitourinary toxicity between anatomy-based inverse optimization and geometric optimization. Int J Radiat Oncol Biol Phys 64:1360–1366

    PubMed  Google Scholar 

  58. Akimoto T, Katoh H, Kitamoto Y, et al. (2006) Rectal bleeding after high-dose-rate brachytherapy combined with hypofractionated external-beam radiotherapy for localized prostate cancer: impact of rectal dose in high-dose-rate brachytherapy on occurrence of grade 2 or worse rectal bleeding. Int J Radiat Oncol Biol Phys 65:364–370

    PubMed  Google Scholar 

  59. Kubo HD, Glasgow GP, Pethel TD, et al. (1998) High dose-rate brachytherapy treatment delivery: report of the AAPM Radiation Therapy Committee Task Group No. 59. Med Phys 25:375–403

    Article  PubMed  CAS  Google Scholar 

  60. Yoshioka Y, Nishimura T, Kamata M, et al. (2005) Evaluation of anatomy-based dwell position and inverse optimization in high-dose-rate brachytherapy of prostate cancer: a dosimetric comparison to a conventional cylindrical dwell position, geometric optimization, and dose-point optimization. Radiother Oncol 75:311–317

    Article  PubMed  Google Scholar 

  61. Sumida I, Shiomi H, Yoshioka Y, et al. (2006) Optimization of dose distribution for HDR brachytherapy of the prostate using attraction-repulsion model. Int J Radiat Oncol Biol Phys 64:643–649

    PubMed  Google Scholar 

  62. Brenner DJ, Hall EJ (1999) Fractionation and protraction for radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 43:1095–1101

    Article  PubMed  CAS  Google Scholar 

  63. Fuller DB, Naitoh J, Lee C, et al. (2008) Virtual HDR CyberKnife treatment for localized prostatic carcinoma: dosimetry comparison with HDR brachytherapy and preliminary clinical observations. Int J Radiat Oncol Biol Phys 70:1588–1597

    PubMed  Google Scholar 

  64. Fowler JF (1989) The linear-quadratic formula and progress in fractionated radiotherapy. Br J Radiol 62:679–694

    Article  PubMed  CAS  Google Scholar 

  65. Wang JZ, Yoshioka Y, Montebello JF, et al. (2008) Effectiveness of hypofractionated stereotactic radiotherapy: how much dose to control prostate cancer? Int J Radiat Oncol Biol Phys 72:S351

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yasuo Yoshioka

Authors
  1. Yasuo Yoshioka
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasuo Yoshioka.

About this article

Cite this article

Yoshioka, Y. Current status and perspectives of brachytherapy for prostate cancer. Int J Clin Oncol 14, 31–36 (2009). https://doi.org/10.1007/s10147-008-0866-z

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10147-008-0866-z

Key words

Search

Navigation