Abstract
As we look towards the future of brachytherapy, there are many new trends that may help to improve cancer treatment. The following areas will be addressed: 1. The use of current and new imaging devices before and during brachytherapy to better define and select the tumour, target, and implanted treatment volumes. 2. The development of three-dimensional target planning systems to provide superior dosimetry and dose volume histograms which will result in optimal treatment planning for either brachytherapy alone or with external beam irradiation. 3. Use of remote afterloading systems with either low dose rate (LDR), intermediate dose rate (IDR), pulsed dose rate (PDR), and/or high dose rate (HDR) incorporated into the more accurately defined tumour and target volumes. 4. The development and application of better mathematical models to correlate LDR, IDR, PDR, and HDR. 5. Technical improvements such as the development and use of new miniature radionuclides, permanent interstitial implants with the use of biologically inert materials, and highly sophisticated remote afterloading systems. 6. Potential applications of combining fractionated HDR with continuous LDR irradiation. 7. Combining brachytherapy with: (a) chemotherapeutic agents; (b) hyperthermia: (c) external beam irradiation. 8. Intraoperative brachytherapy.
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