Afterloading treatment is a procedure in which a highly radioactive source (Iridium 192) is temporarily implanted into the prostate for a short period of time. This type of treatment is also used for gynaecological, bronchial and oesophageal tumours. Afterloading is usually carried out in combination with external radiation therapy as part of a mixed modality treatment.
We give HDR brachytherapy as a boost on the prostate, using 2-3 applications with a weekly intervall in conclusion to external radiation therapy. During a short general anesthesia, hollow needles are guided from perineal into the prostate using ultrasound. These needles are loaded temporarily with the radioactive source following a careful planning intended to protect sensitive tissues such as the urethra. As a rule, it is used in localised but advanced prostate carcinoma. External radiation therapy is used to treat the boundary areas of the prostate and local lymph nodes. The side effects of this combined modality treatment approximately equal those of seed implantation with transient irritation of bladder and bowels
The total procedure lasts about 60-90 minutes. The additional external radiation which precedes the afterloading takes about 5 weeks. After the end of treatment, we recommended quarterly tumor check-ups.