For eligible patients with high-risk prostate cancer receiving EBRT and ADT, brachytherapy boost (LDR or HDR) should be offered.
Iodine-125 and Palladium-103 are each reasonable isotope options for patients receiving LDR brachytherapy; no recommendation can be made for or against using Cesium-131 or HDR monotherapy.
Patients should be counseled about all their care options (surgery, EBRT, brachytherapy, active surveillance, as applicable) in a balanced, objective manner preferably from multiple disciplines.
If choosing brachytherapy, a patient should go to a treatment center following strict quality assurance standards.
To develop this guideline update, an Expert Panel reviewed relevant literature published between 2011 and December 2016. Five randomized controlled clinical trials provided the evidence base for this guideline update. The Brachytherapy for Patients with Prostate Cancer: American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update was published today in the Journal of Clinical Oncology.
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