Complications and side effects of high-dose-rate prostate brachytherapy

Abstract

PurposeTo describe technical challenges and complications encountered during and after high-dose-rate prostate brachytherapy (HDR-BT) and review management of these complications. Methods and MaterialsThe authors performed a systematic review of the literature on toxicities encountered after prostate HDR-BT +/− external beam radiotherapy. A total of 397 studies were identified, of which 64 were included. A focused review of literature regarding the management of acute and late toxicities also performed. ResultsMost acute toxicities include grade 0–2 genitourinary and gastrointestinal toxicity. Overall, Grade 3+ Common Terminology Criteria for Adverse Events toxicity after HDR-BT was low [genitourinary: 0–1%; gastrointestinal 0–3%]. Rates of fistula formation were <1%, and radiation cystitis/proctitis were <14% and more commonly reported in cohorts treated with HDR-BT boost and external beam radiotherapy. ConclusionsHDR-BT both as monotherapy or combined with external beam radiotherapy for prostate cancer is well tolerated. Serious complications are rare.