Brachytherapy

Brachytherapy (or internal radiotherapy) is a localised cancer therapy. It is used for certain stages of cancer and for cancers in certain parts of the body. Brachytherapy may be used in combination with external radiotherapy.

VARIOUS TREATMENT OPTIONS

During brachytherapy, radioactive sources are placed directly inside or next to the tumour. A high dose of radiation is delivered in a very low volume owing to the proximity of the radioactive sources. The radiation level surrounding the radioactive sources quickly decreases, sparing the healthy surrounding tissue from damage. Brachytherapy can be used alone or in combination with surgery and/or external radiotherapy. It is used only for certain stages of cancer and for cancers in certain parts of the body.

There are various treatment options depending on the dose:

 

High-dose brachytherapy

Treatment lasts for several minutes, once or twice a day, for several days.The patient does not need to remain in hospital overnight for treatment.
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Low-dose brachytherapy

The radioactive sources are left in place for several days. Continuous radiation is delivered. The patient is therefore required to remain in hospital. This type of treatment is no longer used in France.

 

Pulsed dose rate brachytherapy

Radiation is delivered once an hour, around the clock.These periods are known as ‘pulses’, which is why the treatment is called pulsed dose rate brachytherapy.Each pulse lasts between 10 and 45 minutes.The patient must remain in hospital for two to six days.Patients are allocated a private room, and visits are restricted. The patient is kept in isolation only during the pulses, so as to protect staff from radiation exposure.Every hour, the patient has 30 minutes of free time in which they can eat, receive visits from staff, etc.
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Brachytherapy with source projectors

This technique uses a miniaturised iridium-192 radioactive source, which is projected into a non-radioactive vector that is placed on or in the area requiring treatment.

 

Prostate brachytherapy using permanent implants

This treatment is nowadays used to treat certain forms of prostate cancer. Radioactive iodine-125 seeds are placed in the prostate gland while the patient is under general anaesthetic. They are left in place indefinitely.

Thyroid treatment using radioactive iodine is not covered here. It falls within the scope of nuclear medicine.

PROSTATE BRACHYTHERAPY WITH IODINE-125

This technique involves placing radioactive sources directly into the prostate tissue, to be left there indefinitely. High doses of radiation are delivered to the tumour, while limiting the amount of radiation to which the bladder and rectum are exposed. Brachytherapy uses permanent implants in the form of iodine-125 seeds.
The seeds are implanted via needles, guided by transrectal ultrasound, while the patient is under general anaesthetic.

It requires close collaboration between the urologist and the specialist brachytherapy radiotherapist. It is used to treat only certain types of localised prostate cancer. The patient only needs to remain in hospital for around 48 hours.
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