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• Interstitial high-dose-rate brachytherapy (IRT HDR BRT) is a promising treatment for central liver tumours • CT-guided IRT HDR BRT is safe for treating extensive tumours • CT-guided IRT HDR BRT could play a role in managing unresectable hepatic malignancies.

BackgroundTo report the clinical outcome of high dose rate brachytherapy as sole treatment for clinically localised prostate cancer.MethodsBetween March 2004 and January 2008, a total of 351 consecutive patients with clinically localised prostate cancer were treated with transrectal ultrasound guided high dose rate brachytherapy. The prescribed dose was 38.0 Gy in four fractions (two implants of two fractions each of 9.5 Gy with an interval of 14 days between the implants) delivered to an intraoperative transrectal ultrasound real-time defined planning treatment volume. Biochemical failure was defined according to the Phoenix Consensus and toxicity evaluated using the Common Toxicity Criteria for Adverse Events version 3.ResultsThe median follow-up time was 59.3 months. The 36 and 60 month biochemical control and metastasis-free survival rates were respectively 98%, 94% and 99%, 98%. Toxicity was scored per event with 4.8% acute Grade 3 genitourinary and no acute Grade 3 gastrointestinal toxicity. Late Grade 3 genitourinary and gastrointestinal toxicity were respectively 3.4% and 1.4%. No instances of Grade 4 or greater acute or late adverse events were reported.ConclusionsOur results confirm high dose rate brachytherapy as safe and effective monotherapy for clinically organ-confined prostate cancer.

PURPOSE: High-dose-rate (HDR) brachytherapy (BRT) and stereotactic body radiotherapy (SBRT) are currently the two treatment options for definitive radiotherapy of prostate cancer, employing extreme hypofractionation. There are only very few studies comparing their dosimetry, all using computed tomography for treatment planning. We present here a real-word dosimetric comparison between SBRT and ultrasound-based virtual HDR-BRT, with both imaging modalities coming from the same patient. METHODS AND MATERIALS: Patients with prostate cancer on a prospective trial evaluating the toxicity of robotic-based SBRT were treated to a total dose of 35 Gy in 5 fractions. Fifteen patients were included in this analysis. During ultrasound-based fiducial implantation, a threedimensional data set as in real HDR-BRT procedure was acquired. Virtual HDR-BRT plans were generated and various organs at risk and prostate dosimetric parameters were evaluated. RESULTS: Concerning prostate, SBRT achieved significant higher D 98 , V 35 Gy, and V 37.5 Gy coverage, whereas virtual HDR-BRT achieved significant higher intratumoral doses reflected in the V 42 Gy and V 52.5 Gy. Rectal D max , V 36 Gy, and V 29 Gy were significantly lower for HDR-BRT with no difference as for V 18 Gy. SBRT was significantly inferior regarding bladder dosimetry (D max , V 36 Gy, V 18 Gy), whereas urethra D max and V 44 Gy where significantly higher at the expense of HDR-BRT. CONCLUSIONS: HDR-BRT is superior regarding rectum and bladder dosimetry, with SBRT being superior relative to urethra dosimetry. A randomized study is warranted to define the best extreme hypofractionated modality.

sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT.

PBM-LED therapy applied prior to RT might be effective in decreasing the incidence and sequelae of radiation-induced skin toxicity in breast cancer patients treated with breast-conserving surgery.

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