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Brachytherapy

From the Greek word "brachys," meaning "short," brachytherapy is a radiation treatment in which the radiation source is located a short distance from the area being treated. Also called "internal radiation", brachytherapy uses tiny radioactive seeds or pellets that are actually implanted inside the body. It can be given as interstitial radiation, where rods, ribbons, or wires are placed inside the tumor tissue, or as intracavitary radiation, where a container of radioactive material is placed inside a body cavity, such as the uterus, vagina, or airway. Over time, a calculated amount of radiation leaks out of the source, and into the tumor site. Brachytherapy can deliver relatively high doses of radiation to the tumor with minimal risk to adjacent organs. This method also provides higher doses of radiation in a shorter time than external beam radiation. Brachytherapy is most commonly used for cancers of the head and neck, breast, uterus, thyroid, cervix, and prostate.

The Dana-Farber/Brigham and Women's Cancer Center has a dedicated brachytherapy team. These highly skilled radiation oncologists, physicists, nurses and therapists have been pioneers in the field of brachytherapy and work together daily to treat patients using this type of treatment.

• High-Dose-Rate (HDR) Brachytherapy

  HDR Brachytherapy delivers a high dose of radiation in a short period of time, approximately 10 minutes. Typically a patient needs 3-5 HDR treatments, given 1-3 times per week over 2-4 weeks. HDR brachytherapy may occasionally be administered once a week before the completion of external beam therapy.

• Low-Dose-Rate (LDR) Brachytherapy

  LDR Brachytherapy delivers the dose of radiation at a much slower rate – typically over 2-4 days – and requires the patient to be isolated in a shielded hospital room because of the radioactivity that remains in the body during that time. Most visitors will be permitted to see the patient during the hospital stay, though there may be some restrictions on the time they spend visiting.

• Ultrasound-Guided Prostate Brachytherapy

  Ultrasound-guided prostate brachytherapy is a relatively new technique, pioneered in the U.S. in the mid-1980s. This form of interstitial brachytherapy is not surgery and usually does not require an overnight stay in the hospital.

  At an initial visit to the clinic, a "volume study" is performed using ultrasound to measure the prostate gland, so that the best treatment can be planned. A few weeks later, the patient returns and is placed under either spinal or general anesthesia for treatment. Tiny radioactive seeds (each one smaller than a grain of rice) are inserted directly into the prostate gland through small needles. The physician uses an ultrasound video image to see the prostate during the procedure, and to make sure that the seeds are implanted correctly. The procedure usually takes 1-3 hours. Afterwards, the patient spends two or more hours in the recovery room while the effects of the anesthesia wear off.