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Home > Mesothelioma articles > Brachytherapy in experimental mesothelioma treatment

Brachytherapy in experimental mesothelioma treatment

Brachytherapy is a type of radiotherapy mesothelioma treatment that implants radioactive material sealed in needles or seeds into or near the tumour.

In other words, brachytherapy is a form of radiation treatment in which tiny pellets containing radioactive material, such as Iodine-125, are implanted directly into the tumor-containing organ, such as into or surrounding the prostate gland in men diagnosed with prostate cancer. Over time, the radiation leaks out of the pellets, or seeds, and into the adjacent tumor site. Brachytherapy can deliver relatively high doses of radiation to the tumor site without seriously affecting adjacent organs.

The use of high-energy radiation from x-rays, gamma rays, neutrons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy, implant radiation, or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that circulates throughout the body. Also called radiotherapy.

Let's consider brachytherapy by the example of prostate.

Interstitial brachytherapy is a technique in which radioactive sources are placed into the prostate gland, delivering radiation from within the prostate. The most common method of brachytherapy is known as the "seed implant", in which multiple radioactive seeds, usually isotopes of iodine or palladium, are inserted into the prostate by needles passing through the base of the scrotum under ultrasound guidance. Other methods of inserting the seeds have also been developed.

The seeds remain in the body permanently, although the radioactivity diminishes over time. The seed implant may be performed as the sole treatment modality in very early stage prostate cancers of low aggressiveness, or it may be combined with an abbreviated (five-week) course of external beam radiation therapy, particularly in cases in which the PSA, Gleason score, or tumor stage would predict a lower likelihood of controlling the cancer with the seed implant alone.

In some cases, radioactive sources, typically an isotope of iridium, are inserted into the prostate gland temporarily and than removed. This is known in some situations as high-dose rate (HDR) brachytherapy and is usually combined with an abbreviated course of external beam irradiation. An advantage of combining external beam radiotherapy with the seed implant or HDR brachytherapy over external beam irradiation alone is that the former approach delivers a higher total radiation dose to the prostate and may result in a higher probability of controlling the cancer.

For patients who are suitable candidates for the seed implant alone, this approach is often attractive, as it avoids both the lengthy course of external beam radiotherapy and the major surgery associated with radical prostatectomy. Disadvantages of the seed implant include its relatively shorter track record than radical prostatectomy or external beam radiation therapy and the fact that it is a minor surgical procedure, which may not be suitable for some patients.

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