Prostate brachytherapy in Europe: growth, practice and guidelines. Therapeutic Radiology and Oncology

摘要

The diagnosis of prostate cancer across Europe is increasing year by year and the majority of the extra cases diagnosed are those with early low risk disease defined by a low PSA and low Gleason score, many of whom are asymptomatic and identified on PSA screening. Optimal management for these patients remains uncertain and spans a range from active surveillance through to radical radiotherapy and prostatectomy. For most of these patients low dose rate seed brachytherapy will be an option providing effective high dose radiation therapy with a favourable side effect profile, particularly when compared with radical external beam treatment or radical prostatectomy. Of importance in this group of relatively young sexually active men it has the best chance amongst the radical treatment options of retaining erectile function . In recognition of the emerging practice guidelines for the development of a low dose rate seed brachytherapy programme were developed through GEC ESTRO in collaboration with the European Association of Urology and the EORTC and published in this Journal six years ago . Similar guidelines were published the previous year by the American Brachytherapy Society .