title: Perspectives of brachytherapy: patterns of care, new technologies, and "new biology".
abstract: Brachytherapy has come a long way from its beginnings nearly a century ago. In recent years, brachytherapy has become ever more sophisticated thanks to a multitude of technological developments, including high-dose rate afterloading machines, image-guidance, and advanced planning systems. One of the advantages of brachytherapy, apart from the well-known capability of delivering highly conformal doses directly to the target, is that it is highly adaptable and can be used as a primary, adjunct, or salvage treatment. However, despite the existence of international treatment guidelines, the clinical practice of brachytherapy varies greatly by region, country, and even institution. In the present article, we provide an overview of recent findings from the Patterns of Care for Brachytherapy in Europe (PCBE) Study and we discuss new technologies used in brachytherapy and the emerging concept of "new biology" that supports the use of high-dose brachytherapy. Compared to the 1990s, the use of brachytherapy has increased substantially and it is expected to continue growing in the future as it becomes ever more precise and efficient.
authors.affiliation: Department of Radiation Oncology, Institut Català d'Oncologia (ICO), University of Barcelona (UB), L'Hospitalet del Llobregat, Barcelona, Spain. Electronic address: guedea@iconcologia.net.
authors.forename: F
authors.initials: F
authors.lastname: Guedea
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D024201:Bystander Effect; D019583:Dose Fractionation, Radiation; D005060:Europe; D006801:Humans; D007430:Intraoperative Care; D009369:Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D058958:Organs at Risk; D011050:Policy Making; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018787:Radiation Oncology / Q000706:statistics & numerical data; D016634:Radiosurgery; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided; D015398:Signal Transduction / Q000528:radiation effects; D011795:Surveys and Questionnaires
keywords: Brachytherapy; Breast; Curiethérapie; Dose escalation; Escalade de dose; Gynaecological; Gynécologique; Prostate; Sein