Transperineal Permanent Brachytherapy of Localised Prostate Cancer

Context: In absence of prospective randomized trials determining the optimal management of localized prostate cancer remains undefined. Objective: To develop and disseminate an update on outcome of different treatment modalities, recommendations and guidelines of transperineal prostate brachytherapy. Evidence acquisition: in the past decade, the average number of brachytherapy patients per centre has increased by at least 10%. Brachytherapy for localised prostate cancer in particular is gaining more popularity in European countries. Prostate brachytherapy is possibly the most propagated minimally invasive therapy mode in the arsenal of cancer therapy at this time. Evidence synthesis: A multidisciplinary approach to prostate cancer implies the necessity of visibility for each involved discipline into different therapeutic modalities. This paper reviews the basic principles of brachytherapy for prostate cancer. Biochemical disease-free survival results of different centres are compared with surgery and external-beam radiotherapy. This paper provides an update on the indications and rationales of different techniques according to guidelines and recommendations on interstitial radiotherapy. Conclusion: A worldwide rise in performed prostate cancer brachytherapy, low morbidity and successful outcomes indicate brachytherapy has a prominent role in the treatment of prostate cancer. (C) 2008 European Association of Urology. Published by Elsevier B.V. All rights reserved.