Enhanced Cancer Treatment with Adjuvant Brachytherapy

A cancer diagnosis brings a whirlwind of emotions and decisions, especially when exploring treatment options. A promising approach is adjuvant brachytherapy, which is a treatment that combines internal radiation therapy with other cancer treatments to enhance effectiveness and reduce the risk of recurrence. This targeted strategy can lead to improved outcomes. Discussing this option with your oncologist ensures a treatment plan tailored to your needs and priorities. 

What Is Brachytherapy? 

Brachytherapy involves placing radioactive material directly inside or near the tumor through applicators or needles. Unlike external beam radiation therapy (EBRT), which delivers radiation from outside the body, brachytherapy enables high-dose radiation internally to target cancer cells while sparing surrounding healthy tissues. This precise delivery is especially effective in treating cancers where the tumor is localized, such as breast, prostate, cervical, or skin cancers. 

The Power of Combining Therapies 

Cancer treatment often requires a multifaceted approach, as no single strategy fits all cases. Combining therapies, such as adjuvant brachytherapy, with other modalities usually increases the effectiveness of primary treatments and reduces the likelihood of recurrence. For instance, after a breast-conserving surgery like a lumpectomy, brachytherapy can deliver radiation directly to the tumor bed, significantly lowering the chance of cancer returning. Similarly, in prostate cancer, integrating brachytherapy with external beam radiation therapy (EBRT) or hormone therapy can provide better control for aggressive or advanced cases. In cervical cancer, a coordinated plan involving brachytherapy, EBRT, and chemotherapy can improve survival rates and quality of life. Addressing cancer from multiple angles through these multi-therapy approaches not only targets the disease more comprehensively but also improves both short-term and long-term outcomes for patients. 

Brachytherapy as an Adjuvant Therapy 

Brachytherapy can be used as a standalone treatment (monotherapy) or in combination with other therapies (adjuvant therapy), depending on the type and stage of cancer and patient-specific factors. Here’s how it is utilized: 

• Cervical Cancer: In cases of locally advanced cervical cancer, brachytherapy is combined with EBRT and chemotherapy. This multimodal approach has substantially improved survival rates and locoregional control.  

• Endometrial Cancer: After surgery, adjuvant brachytherapy is frequently employed to reduce the risk of vaginal vault recurrence. With low recurrence rates and minimal late toxicity, brachytherapy has become a cornerstone of post-surgical treatment for endometrial cancer, contributing to better long-term outcomes. 

• Prostate Cancer: For intermediate- to high-risk cases, brachytherapy is often paired with EBRT to enhance treatment outcomes. This combination addresses aggressive forms of prostate cancer more effectively, improving local tumor control and reducing recurrence rates, thereby improving overall survival. 

• Breast Cancer: Brachytherapy has also emerged as a valuable adjuvant treatment for early-stage breast cancer, especially following breast-conserving surgery (lumpectomy). Techniques like accelerated partial breast irradiation (APBI) involve delivering radiation directly to the tumor bed, significantly reducing the risk of local recurrence while sparing surrounding healthy tissues. This targeted approach shortens treatment duration compared to whole-breast irradiation and helps patients return to everyday life more quickly. 

Adjuvant brachytherapy’s ability to deliver highly localized radiation minimizes side effects while enhancing the efficacy of primary treatments. Across a spectrum of cancers, this approach offers a tailored and effective way to improve patient’s survival rates and quality of life. 

Patient Perspectives 

Patients undergoing brachytherapy often feel relieved knowing the treatment is targeted and minimally invasive. Many appreciate the shorter treatment duration and fewer side effects than traditional radiation therapy. Personal stories from patients who have successfully undergone brachytherapy can provide hope and encouragement to others facing similar diagnoses. 

Success Rates  

Brachytherapy’s success rates as an adjuvant therapy are impressive across various cancer types. Combining brachytherapy with other treatments often leads to improved survival rates, better local control of the disease, and reduced side effects. 

• Breast Cancer: Studies show that brachytherapy following lumpectomy reduces local recurrence rates to approximately 4% over ten years, compared to 7% with lumpectomy alone. Furthermore, it minimizes radiation exposure to the heart and lungs, enhancing patient safety ⁽¹⁾. 

• Prostate Cancer: Combining brachytherapy with EBRT achieves 10-year biochemical control rates of 85-90% for intermediate- to high-risk patients, significantly higher than using either therapy alone.⁽²⁾ 

• Cervical Cancer: The inclusion of brachytherapy in treatment regimens has improved outcomes. Image-guided brachytherapy combined with radio-chemotherapy leads to excellent Local Control (91%), Pelvic Control (87%), Overall Survival (74%), a with limited severe morbidity. ⁽³⁾ 

The Role of Adjuvant Brachytherapy in Future Cancer Care 

As advancements in cancer treatment continue, the role of brachytherapy as an adjuvant therapy is expanding. Innovations such as image-guided brachytherapy (IGBT) and the integration of artificial intelligence are improving precision and outcomes. Research also explores its potential in treating previously untreatable cancers or as a standalone option for early-stage cancers. 

The incorporation of brachytherapy into multidisciplinary cancer care teams underscores its importance. By working alongside surgeons, medical oncologists, and radiation oncologists, brachytherapy specialists ensure that patients receive a comprehensive and cohesive treatment plan. 

References: 

1. Breast-Conserving Surgery Followed by Partial or Whole Breast Irradiation: Twenty-Year Results of a Phase 3 Clinical Study 
   Polgár, Csaba et al. International Journal of Radiation Oncology, Biology, Physics, Volume 109, Issue 4, 998 – 1006 

2. Ten-year survival after High-Dose-Rate Brachytherapy combined with External Beam Radiation Therapy in high-risk prostate cancer: A comparison with the Norwegian SPCG-7 cohort.  Wedde TB, Småstuen MC, Brabrand S, et al. Radiother Oncol. 2019 Mar;132:211-217. doi: 10.1016/j.radonc.2018.10.013. Epub 2018 Oct 30. PMID: 30389241. 

3. Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study.  Sturdza A, Pötter R, Fokdal LU, et al. Radiother Oncol. 2016 Sep;120(3):428-433. doi: 10.1016/j.radonc.2016.03.011. Epub 2016 Apr 29. PMID: 27134181.