title: GEC/ESTRO recommendations on high dose rate afterloading brachytherapy for localised prostate cancer: an update.
abstract: BACKGROUND
  HDR afterloading brachytherapy (HDRBT) for prostate cancer is now established as an effective technique to achieve dose escalation in the radical treatment of localized prostate cancer. The previous guidelines published in 2005 from GEC ESTRO and EAU have been updated to reflect the current and emerging roles for HDRBT in prostate cancer.
  
  
  METHODS
  The indications for HDRBT in dose escalation schedules with external beam are wide ranging with all patients having localized disease eligible for this technique. Exclusion criteria are few encompassing patients medically unfit for the procedure and those with significant urinary outflow symptoms.
  
  
  RESULTS
  Recommendations for patient selection, treatment facility, implant technique, dose prescription and dosimetry reporting are given.
  
  
  CONCLUSIONS
  HDRBT in prostate cancer can be practiced effectively and safely within the context of these guidelines with the main indication being for dose escalation with external beam. HDRBT used alone is currently under evaluation and its role in focal treatment and recurrence will be areas of future development.
authors.affiliation: Mount Vernon Cancer Centre, Northwood, UK. peterhoskin@nhs.net
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hoskin
authors.forename: Alessandro
authors.initials: A
authors.lastname: Colombo
authors.forename: Ann
authors.initials: A
authors.lastname: Henry
authors.forename: Peter
authors.initials: P
authors.lastname: Niehoff
authors.forename: Taran
authors.initials: T
authors.lastname: Paulsen Hellebust
authors.forename: Frank-Andre
authors.initials: FA
authors.lastname: Siebert
authors.forename: Gyorgy
authors.initials: G
authors.lastname: Kovacs
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D017410:Practice Guidelines as Topic; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D014463:Ultrasonography
keywords: Brachytherapy; Guidelines; High dose rate; Prostate cancer