Brief Opinion
The Case for Brachytherapy: Why It Deserves a Renaissance

https://doi.org/10.1016/j.adro.2020.10.018Get rights and content
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Abstract

The recent global events related to the coronavirus disease of 2019 pandemic have significantly changed the medical landscape and led to a shift in oncologic treatment perspectives. There is a renewed focus on preserving treatment outcomes while maintaining medical accessibility and decreasing medical resource utilization. Brachytherapy, which is a vital part of the treatment course of many cancers (particularly prostate and gynecologic cancers), has the ability to deliver hypofractionated radiation and thus shorten treatment time. Studies in the early 2000s demonstrated a decline in brachytherapy usage despite data showing equivalent or even superior treatment outcomes for brachytherapy in disease sites, such as the prostate and cervix. However, newer data suggest that this trend may be reversing. The renewed call for shorter radiation courses based on data showing equivalent outcomes will likely establish hypofractionated radiation as the standard of care across multiple disease sites. With shifting reimbursement, brachytherapy represents the pinnacle in hypofractionated, conformal radiation therapy, and with extensive long-term data in support of the treatment modality brachytherapy is primed for a renaissance.

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Disclosures: The listed authors declare no actual or potential conflicts of interest. There were no grants, monies, or other financial incentives or coercions used or offered in the preparation of this manuscript. This manuscript has not been presented or published, in part or in full, before this submission. Dr Paul L. Nguyen has consulted for Ferring, Janssen, Astellas, Bayer, Nanobiotix, Boston Scientific, Augmenix, Blue Earth, Cota, and Dendreon, and has received research funding from Janssen, Bayer, and Astellas. Dr Daniel Petereit has received funding from the following foundations and the National Cancer Institute to support his cancer disparity program, Walking Forward: Bristol-Myers Squibb Foundation, Polo Ralph Lauren Foundation, Irving A Hansen Memorial Foundation, and the National Institutes of Health (R01CA240080-01). Dr Nikhil G. Thaker reports personal fees from McKesson Specialty Health. Dr Sushil Beriwal has consulted for Varian and reports personal fees from Via Oncology. Dr Douglas Arthur has consulted for Advanced Radiation Therapy, Inc.

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Co-first authors.

Published by Elsevier Inc. on behalf of American Society for Radiation Oncology.