HDR brachytherapy is a form of internal radiotherapy. The doctor implants the radiation source in the immediate vicinity of the tumor or directly into the tumor tissue. HDR brachytherapy is often used for prostate cancer.
Depending on the findings, this form of internal radiotherapy can be combined with
combined.
The word "brachy" in the medical term brachytherapy means "short or near". In the variant of this therapy, HDR stands for "high dose rate" and refers to the high dosage within a very short time. This distinguishes HDR brachytherapy from LDR brachytherapy ("low dose rate") with a low dose over a longer period of time.
The more protracted, low-dose rate treatment with LDR is suitable for smaller, low-growth tumors. High-dose rate HDR brachytherapy, on the other hand, is only suitable for the internal irradiation of larger, fast-growing tumors. These include non-scattered prostate cancer and liver cancer as well as
In the high-dose HD variant of targeted radiation from the inside, the dosage is more than 12 Gy/h. Gy means Gray - this is the unit of measurement for the absorbed dose from particle radiation.
For comparison: In the case of a much lower dose of LDR brachytherapy, which is carried out over a longer period of time, the dose is 2 to a maximum of 12 Gy/h.
The doctor adjusts the strength of the necessary dose to the
- size,
- nature and
- development prognosis
of the cancerous tumor.
HDR brachytherapy is a form of radiation therapy "from the inside". It briefly exposes the tumor tissue to a high dose of radiation © rumruay | AdobeStock
Brachytherapy with HDR is only suitable for the treatment of locally clearly defined tumors without metastases (spread). It is preferably used for locally severe tumors, such as a prostate tumor.
The doctor often combines this very individual method of internal tumor irradiation with external irradiation (percutaneous irradiation).
In individual cases, HDR brachytherapy is also used as a booster . It is then used for saturation after conventional external radiation therapy. HDR brachytherapy as a saturating booster radiotherapy is gentler on the patient and less stressful for their health than continuing the external radiotherapy seamlessly.
HDR brachytherapy is usually carried out under local anesthesia. The treatment can be carried out on an outpatient basis without hospitalization and the patient can return home after a few hours.
On the recommendation of the attending physician, many patients opt for a gentle spinal anesthetic (spinal anesthesia).
At the beginning of HDR brachytherapy for prostate cancer, the attending physician inserts a bladder catheter into the patient's bladder.
The radiation material is then placed directly in or on the tissue of the prostate tumor using medical technology. The doctor administers hollow needles with iridium-192 via a template and transport tubes.
The doctor assesses the patient's tumor situation and initiates the so-called "afterloading" based on his findings. This is the implantation of iridium-192 using the afterloading procedure.
The doctor inserts the hollow needles with the radioactive iridium into the tumor tissue for a very short period of time in precise doses. Correct placement is computer-assisted and ensured by ultrasound monitoring.
This therapy is also suitable for gentle follow-up treatment after external radiotherapy.
The actual HDR brachytherapy, i.e. the duration of radiation exposure, is very short and only takes a few minutes. Under local anesthesia, the treatment is not painful for the patient.
Possible damage to neighboring tissue and skin can be reliably avoided. A longer stay in hospital is not usually necessary for HDR brachytherapy.
HDR brachytherapy with targeted and timely doses of iridium-192 is still relatively new. It is increasingly being used in radiation treatment, especially for prostate cancer with aggressive tumors that do not spread.
The advantage of this treatment is the very high, concentrated radiation with a very short range. This means that the strong radiation only damages the tumor tissue, while healthy tissue is spared. A longer stay in hospital is usually unnecessary.
The dose of radiation to be administered can be adjusted very individually. If necessary, afterloading is possible to increase the dose after external radiation therapy. This type of treatment is particularly gentle on healthy tissue and the skin around the tumor.
