High-Dose Rate Brachytherapy Zeros in on Prostate Cancer
When it comes to treating prostate cancer with radiation, a pinpoint beats a spotlight. That’s the premise behind high-dose rate (HDR) brachytherapy, which has become a well-established treatment for localized prostate cancer. The only HDR prostate brachytherapy program in Nebraska is offered by the CHI Health Henry Lynch Cancer Center at Creighton University Medical Center – Bergan Mercy.
“Generally, brachytherapy enables higher doses to be delivered to the tumor than conventional methods of using external beam radiation, and so it certainly allows us a better ability to provide local tumor control, thereby increasing our chances for cure,” said CHI Health radiation oncologist Hadi Zahra, MD.
With low-dose rate brachytherapy, seeds commonly containing palladium or iodine are implanted in the tumor and stay in the patient.
With high-dose rate brachytherapy, catheters are temporarily placed into the prostate trans-perineally, and a high dose of radiation is delivered over a span of minutes, often in two sessions per day, and removed immediately after that day’s treatment.
“With high-dose rate, since we apply the radiation after we put in temporary catheters, it allows us to better fine-tune the radiation to the at-risk tissues, and to better modulate the dose around healthy tissues that we hope to preserve,” Dr. Zahra said.
That inverse relationship – high doses going to the cancerous area and low or no doses to normal tissues – is why brachytherapy has been called the ultimate in conformal therapy.
“Numerous studies have shown that when you use brachytherapy as a radiation treatment strategy, you have an ability to deliver higher doses more safely and thereby improve PSA outcomes,” Dr. Zahra said.
The advance expands treatment options for prostate cancer patients.
“Individuals can be considered for high-dose rate brachytherapy as a single modality treatment called monotherapy in the low-or favorable intermediate-risk groups,” Dr. Zahra said.
For individuals with high-risk or in an unfavorable intermediate-risk group for prostate cancer, high-dose rate brachytherapy can be combined with external beam radiation treatment in appropriately selected patients.
“It’s an exciting area and certainly an opportunity to deliver radiation therapy in a sophisticated way,” Dr. Zahra said.