Brachytherapy

Types

High Dose Rate Brachytherapy

High dose rate (HDR) brachytherapy is one of the latest advances in brachytherapy treatment methods. In this procedure, radiation oncologists insert plastic tubes or needles directly into the tumor or place a hollow applicator inside a body cavity. A remote-controlled machine inserts radioactive material into the tubes and leaves it in place in the tumor for a few minutes. Several treatments may be given during a few days to weeks.

HDR brachytherapy is highly effective for treatment of cervical cancer as an alternative to surgical removal of the cervix and uterus. Physicians also use it to prevent recurrence of uterine cancer in the vagina following surgery. In addition, HDR brachytherapy is used to reduce the risk of recurrence of soft tissue sarcoma following surgery.

Low Dose Rate Brachytherapy

Low dose rate (LDR) brachytherapy involves exposure to radioactive sources for hours to days instead of minutes. Ocular melanoma is one example of a tumor that can be treated with LDR brachytherapy. To treat ocular melanoma, specialists place radioactive seeds in a small case that resembles a bottle cap, and sew it on the surface of the eye directly over the location of the tumor. The case with seeds remains in place for several days.

LDR brachytherapy has been used in combination with external radiation and chemotherapy for treatment of bile duct cancer when the cancer cannot be surgically removed.

Permanent Prostate Brachytherapy

Permanent prostate brachytherapy is a form of LDR brachytherapy in which physicians implant between 60 and 120 rice-sized radioactive seeds into the prostate with guidance from ultrasound and X-rays. The seeds contain a radioactive isotope that kills cancer cells. The seeds are placed during a procedure in which patients usually are under general anesthesia for two hours or less. The seeds are left in place to give off low doses of radiation for weeks or months. Prostate brachytherapy may also be performed with temporary high dose rate implants.

Intravascular Brachytherapy

Intravascular brachytherapy is given by specialists in radiation oncology and interventional cardiology. Physicians advance a special catheter to the narrowed heart artery, and place a wire (also called a seed train or ribbon) containing the radiation inside the catheter. Care providers then deliver a precisely calculated dose of radiation to the treatment site, before withdrawing the wire and catheter. A conventional angioplasty treatment takes about 90 minutes. Intravascular brachytherapy generally adds only a few minutes to the procedure time.