Brachytherapy is derived from the Greek term brachys, or short, and relates to a form of radiotherapy in which the radioactive source is placed close to the target.  While different methods of placement are employed based on the condition of interest, prostate brachytherapy refers to interstitial placement of radioactive seeds for clinically localized prostate cancer.  There are two major forms of prostate brachytherapy currently in use today:  permanent, low-dose rate (LDR) brachytherapy, in which seeds (typically iodine¹²⁵ or palladium¹⁰³) are permanently implanted and emit a low dose of radiation over several months.

Protons are positively charged subatomic particles that feature particular characteristics of interest for clinical use.  Specifically, proton beams are known to deposit the bulk of their radiation energy at the end of their range of penetration, or what is referred to as the Bragg peak.  This feature allows for targeted dosing of proton radiation to a particular tumor site, with minimal dose delivery to the surrounding normal tissue, offering a theoretical advantage over the delivery of photons (i.e., gamma- or X-rays), which deposit their energy along a more disseminated distribution.  This has led to an increase in the use of protons to treat clinically localized prostate cancer, in which the tradeoff between tumor control and perineal toxicity is an important consideration.

Stakeholder groups invited to participate:

Clinical Organizations:

• American Society for Therapeutic Radiology and Oncology (ASTRO)
• American College of Radiology (ACR)
• Amercian Society of Clinical Oncology (ASCO)
• American Urological Association (AUA)

Patient Advocacy Organizations:

• American Cancer Society (ACS)
• Us Too International (USTOO)

Background Materials & Key Questions

Brachytherapy Overview 

Proton Beam Therapy Overview 

Brachytherapy/Proton Beam Therapy Scoping Committee Call Agenda and Key Questions

Brachytherapy/Proton Beam Therapy Scoping Committee Call Summary

Brachytherapy/Proton Beam Therapy Evidence Review Group

Mid-Cycle Review Documents 

Economic Model of Multiple Radiation Therapy Treatments for Low-Risk Prostate Cancer: Overview

Systematic Review of Brachytherapy & Proton Beam Therapy for Low-Risk Prostate Cancer: Preliminary

Final Appraisal Documents 

Executive Summary: Brachytherapy and Proton Beam Therapy for Treatment of Clinically Localized, Low-Risk Prostate Cancer  

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Herbert A. Klein, M.D., Ph.D.  - Clinical Professor Radiology, U. of Pittsburgh   |24.3.147.xxx |2009-08-19 02:32:08 Can you please help me home in on references to substantiate the statement on p. 10 of the executive summary that PBT involves greater radiation exposure outside the prostate than does brachytherapy? Thank you very much. Reply

Victor Muñoz-Garzón  - Head of Radiation Oncology (CHUVI_Vigo) Spain   |85.56.197.xxx |2009-09-17 09:37:16 We use IMRT , 3DCRT and Brachytherapy , but no PBT. However brachytherapy is the closest (conformal) possible radiation ,not in vain, Brachytherapy is from "inside", perhaps that fact is enough for any more external radiation dose to any tissue outside the prostate. Reply

victor Munoz-Garzón  - Head of Radiation Oncology (CHUVI_Vigo) Spain   |217.124.245.xxx |2009-08-20 00:11:34 HDR brachytherapy is a excellent treatment for low risk prostate cancer . There are a lot of papers , even random trials (benjamin guix , Barcelona etc)or comparision pair to pair HDR vs LDR (Alvaro Martinez , WBH Detroit ). HDR is also much cheaper, so it does not mean not to defend its use (except for business reasons) or at least so some reviews as UpToDate ...etc. they give the scientific value that it deserves. Sincerely Victor Reply

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