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Radiation Oncology • Genitourinary Cancers
How to you sequence HDR brachytherapy for definitive prostate cancer treatment?
In the case of two fractions, would you complete two fractions one week apart? Or admit after the first and do the second fraction the next day?
In practice, it can take nearly all day for one HDR implant. Is it more favorable to administer treatments one day apart with an overnight admission vs better to space the treatments apart?
Answer from: Radiation Oncologist at Academic Institution
For our prostate cancer patients (favorable risk, favorable intermediate risk, and biopsy proven local recurrences) who are treated with 2 HDR fractions (13.5 Gy x 2 or 12 Gy x 2), our typical sequence is two implants separated by 1 week. We sometimes separate the implants by 2 weeks, but this is be...
Answer from: Radiation Oncologist at Community Practice
We have been doing HDR monotherapy since 2000. We started out with 700x6 fraction with two implants 2 weeks apart, then 950x4 fractions with 2 implants 2 weeks apart. We now do 1350x2 with 2 implants either 1 or 2 weeks apart for the last 8 years. The patient does very well. We seem to see a little ...
Answer from: Radiation Oncologist at Academic Institution
I've mostly done HDR monotherapy 27 Gy divided in 2 fractions q 2 weeks as well, based on Beaumont's original design, but likewise, have seen no qualitative differences in outcomes, quality of life in those I've done at one week intervals for a variety of reasons.
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