HDR Brachytherapy & LDR Brachytherapy

About

High Dose Rate Brachytherapy & Low Dose Rate Brachytherapy

Prostate cancer is the most common cancer among American men with about one in seven men diagnosed during his lifetime. The Oregon Clinic Radiation Oncologists Dr. Eric Hansen and Dr. Stephen Bader are on the cutting edge of treating prostate cancer, offering a new treatment called high-dose rate (HDR) brachytherapy. They expanded their practice to include HDR brachytherapy because it can improve cure rates and reduce side effects compared to traditional treatments.

Currently, a common prostate cancer treatment is low-dose rate (LDR) brachytherapy, which places permanent radioactive seeds in the prostate that release radiation for a few months. LDR brachytherapy can be an effective treatment, but is not without frustrations. Because of the radioactivity men treated with a traditional LDR implant must follow radiation safety precautions for about two to three months. Also, radioactive seeds can move from their intended position after the implant due to swelling and sometimes that can increase side effects.

New research shows that HDR brachytherapy is an effective alternative to LDR brachytherapy, with shorter, stronger, and more precise radiation treatment. During HDR brachytherapy, a single small radioactive source is temporarily implanted into the prostate under robotic control while the patient is under anesthesia. A computer is used to control the exact location and duration of the radiation to precisely target the prostate cancer. The procedure takes only about two to three hours and the radiation treatment itself is over in about ten minutes. After treatment, there is no radioactivity left in the patient’s body so there is no risk of second-hand exposure to friends and family. Also, there is no risk of radioactive seed migration since the implant is temporary, not permanent as with LDR brachytherapy.

Introducing HDR prostate brachytherapy reflects the deep commitment of The Oregon Clinic and its providers to be on the forefront of evidence-based medicine offering our patients the most effective, least invasive treatments available.

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Dr. Eric Hansen and Dr. Stephen Bader at The Oregon Clinic Radiation Oncology

 

Our Team

Areas of Focus:
Prostate Cancer, Stereotactic Radiosurgery using the Gamma Knife, Benign and Malignant Tumors of the Brain, Breast Cancer, Gastrointestinal Cancer
Areas of Focus:
Image-guided Intensity Modulated Radiotherapy (IGRT/IMRT), Radiosurgery (Gammaknife), Stereostatic Body Radiotherapy (SBRT), High Dose Rate (HDR) Brachytherapy, 3D Conformal Radiotherapy

What to Expect

How It Works

With HDR brachytherapy, the radiation oncologist and computer software control the location and duration of source delivery, making it possible to tailor the dose precisely to the tumor. The catheter(s) and radioactive source are placed temporarily inside the body and are removed after the appropriate amount of radiation has been delivered.

During Treatment

The computer-controlled robotic afterloader delivers the radiation source to the tumor through a small hollow tube called a catheter, which has been placed in the appropriate location in the body. This procedure may require anesthesia and a surgical procedure. Your doctor and team will control this treatment from outside the treatment room, monitoring you as the therapy is being given. Radiation is usually delivered in multiple doses, once or twice per day, or once or twice per week, for 10 to 30 minutes per treatment.

FAQ

With HDR brachytherapy, the radiation oncologist and computer software control the location and duration of source delivery, making it possible to tailor the dose precisely to the tumor. The catheter(s) and radioactive source are placed temporarily inside the body and are removed after the appropriate amount of radiation has been delivered. 

HDR was developed to reduce risk of cancer recurrence while shortening the amount of time it takes to get radiation treatment. HDR also limits the dose of radiation (and associated side effects) to surrounding normal tissue.

Most patients feel little discomfort during brachytherapy. There is no residual radioactivity when the treatment is completed. You may be able to go home shortly after the procedure, resuming your normal activities with few restrictions. 

Other Benefits Include:

  • Consistent, high-quality prostate implants through improved dose tailoring and real-time computer planning
  • Better dose coverage improves cure rates and reduces side effects
  • Eliminates LDR radiation seed migration since the HDR implant is temporary
  • Eliminates the need for patients and families to use radiation safety precautions since there are no radioactive seeds
  • Extends eligibility to men with extraprostatic extension (stage T3a) or seminal vesicle invasion (stage T3b), thanks to sophisticated computer planning and flexibility
  • Can eliminate or reduce the need for extended androgen therapy and its subsequent side effects

After breast cancer surgery, radiation treatments help prevent the breast cancer from coming back. Breast Brachytherapy means placing radiation sources inside next to a cancer, or inside an area that may contain remaining cancer after surgical removal of the tumor.  This allows the doctor to target only the part of the breast where the tumor was located rather than the whole breast.

Compared to LDR, HDR has Several Benefits:

  • The treatment time is shorter — 1 week versus up to 7 with LDR. Intraoperative HDR has even shorter treatment time because it's done during surgery.
  • Radiation is given only to the area where the cancer is most likely to come back. Less of your body receives radiation, so there may be fewer side effects.
  • The preliminary results from the small number of studies done so far show a very low risk of recurrence after internal radiation.

 

Brachytherapy, puts a source of radiation in or near the cancer. The radiation source is placed in a device in the vagina (and sometimes in the cervix).

Prostate cancer is the most common cancer diagnosed in men in the United States. New methods of treatment cause fewer side effects than older methods. These treatments have excellent survival rates. Depending on the stage of disease and your general health.

For prostate cancer patients, the implant is placed in or near the tumor. You will be getting high-dose rate brachytherapy (HDR) delivered through a system of catheters (a small, flexible tube). These catheters will be placed in the operating room.

Advantages of HDR:

  • Consistent, high-quality prostate implants through improved dose tailoring and real-time computer planning
  • Better dose coverage improves cure rates and reduces side effects
  • Eliminates LDR radiation seed migration since the HDR implant is temporary
  • Eliminates the need for patients and families to use radiation safety precautions since there are no radioactive seeds left in patient
  • Extends eligibility to men with extraprostatic extension (stage T3a) or seminal vesicle invasion (stage T3b), thanks to sophisticated computer planning and flexibility
  • Can eliminate or reduce the need for extended androgen therapy and its subsequent side effects