Organ-confined prostate carcinoma radiation brachytherapy compared with external either photon- or hadron-beam radiation therapy. Just a short up-to-date

C. Alberti

L.D. of Surgical Semeiotics, University of Parma, Parma (Italy)

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• Oncology

Both low dose rate (LDR) permanent either 125I or 103Pd seed implant and high dose rate (HDR) 192Ir temporary implant are an excellent way to release high dose of ionizing radiations to cancerous lesions while significantly sparing the surrounding healthy tissues. Therefore, the radiation brachytherapy, among the established treatment options of organ-confined prostate carcinoma – interstitial radiofrequency, high intensity focused ultrasound, cryotherapy – has gained large acceptance in the last decades. The LDR permanent interstitial radioactive seed implantation is often used as monotherapy for low risk prostate carcinoma whereas the HDR temporary implant may useful to treat intermediate-to-high risk prostate tumors as a radiation boost to combined external beam radiation therapy (EBRT). On the other hand, with recent refinement of EBRT techniques – either three-dimensional conformal- or intensity-modulated radiotherapy, cyber-knife radiosurgery with even 4D-high resolution image-guided tracking – high doses of X-rays may be precisely delivered to prostate malignant lesions without increasing toxicity for surrounding normal structures. Also hadron therapy is an increasingly successful technique that allows the release of effective energy of protons (H+), neutrons or carbon ions (126 C) to the limited extent of the cancerous target site, thus destroying malignant lesion with millimetric precision – just as bloodless surgery – while less damaging the neighbouring healthy tissues. Looking to the near future, even more effective oncotherapy modality appears to be the use of antiprotons because of their highly confined energy deposition at well defined body dept around the annihilation point in contact with protons of the ordinary matter, so targeting only a very limited body volume.

Corresponding Author: Contardo Alberti, MD; mobile: +39.331.9823032

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