For such patients, survival rates would likely be extremely high regardless of the local therapy chosen — whether it is brachytherapy, external beam radiotherapy, or surgery.

“Because of this, patients frequently face a difficult decision as treatment comes down to a choice between multiple highly effective options. It is incumbent upon physicians to provide a fair and balanced discussion of those options so patients are able to make the most informed, and thereby comfortable, decision that they possibly can,” he said.


Side effect profiles differ among treatment options, but so do follow-up implications and logistics of the treatments themselves.

“It is my feeling that HDR brachytherapy compares very favorably to both external beam treatment as well as surgery in terms of cancer control rates and rates of treatment-related complications,” Krauss explained.

Having demonstrated the safety of single fraction brachytherapy treatment in this report, the next step is to determine the optimal single fraction HDR dosing regimen, he said. The current protocol open at William Beaumont Hospital is evaluating the same treatment with an approximately 10 percent increase in the prescription dose.

Given the low toxicity rates seen in the published report, Krauss and his colleagues are confident that this level of dose escalation will be well-tolerated and potentially result in improved disease control rates with long-term follow-up.

HDR brachytherapy is used to treat a wide range of cancers: most notably prostate, breast, and gynecologic malignancies, he said. It is used less commonly as adjuvant therapy for sarcomas and head and neck cancers and occasionally as a palliative treatment in gastrointestinal and lung cancer.

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