Brachytherapy

Brachytherapy is a conventional form of internal radiation therapy in which sealed radioactive sources are placed inside, within, or very near a tumor or tumor bed. Because the source is close to the target, brachytherapy can deliver a high local radiation dose while reducing exposure to surrounding normal tissue compared with treating a larger area from outside the body.

Description

Overview

Brachytherapy, also called internal radiation therapy or implant radiation therapy, places radioactive material directly into or near a cancer. The word comes from the Greek root for “short distance,” which captures the basic idea: radiation is delivered very close to the tumor rather than from a distant external beam. It is a mainstream radiation oncology treatment performed by a specialized team that may include a radiation oncologist, medical physicist, dosimetrist, radiation therapist, surgeon/procedural specialist, nurses, and radiation-safety personnel.

Main forms

Low-dose-rate (LDR) brachytherapy may involve temporary sources left in place for days or permanent radioactive seeds, especially in prostate cancer. High-dose-rate (HDR) brachytherapy uses a temporarily inserted source, usually through applicators or catheters, for minutes per fraction. Pulsed-dose-rate (PDR) brachytherapy delivers repeated short pulses to simulate LDR biology. Placement techniques include intracavity brachytherapy, interstitial brachytherapy, surface/mold treatments, episcleral eye plaques, and radioembolization for liver tumors.

Common disease uses

Very common or well-established uses include prostate cancer seed implants or HDR brachytherapy; cervical cancer brachytherapy as a critical part of definitive chemoradiation; endometrial and vaginal cuff brachytherapy; selected accelerated partial-breast irradiation after lumpectomy; plaque brachytherapy for uveal melanoma; skin brachytherapy for selected non-melanoma skin cancers; and boosts or definitive treatment for selected head and neck tumors. Specialized applications may be used for anal, rectal, esophageal, penile, bladder, lung/endobronchial, liver, and brain tumors depending on disease site, anatomy, prior radiation, and treatment intent.

Benefits and limitations

Brachytherapy can concentrate dose tightly in the tumor region, shorten treatment schedules, and spare nearby organs in selected patients. It is also procedure-dependent: the quality of applicator/catheter placement, imaging, dose planning, and team experience matters. Side effects depend on the treated site and may include urinary, bowel, sexual, vaginal, skin, mucosal, pain, bleeding, infection, anesthesia/procedure, and radiation-safety issues. It is not a single treatment for all cancers; eligibility depends on tumor type, stage, anatomy, prior treatment, and goals of care.

Evidence status

This is a conventional protocol and should sit at WooWoo 0. It is supported by mature radiation-oncology practice, specialty-society guidelines, and disease-specific consensus statements, especially for prostate, gynecologic, breast, skin, and ocular applications.

All Protocols