The role of brachytherapy in the 21^st century for prostate cancer

Men presenting with clinically confined prostate cancer have a variety of established treatment options, among them brachytherapy is gaining increased acceptance, even in the absence of randomized comparative data between brachytherapy, surgery and external radiotherapy. This review summarizes the results of low dose rate transrectal-guided transperineal permanent seed implantation brachytherapy. We present the evolution of the different treatment planning techniques and a comprehensive review of published mature data on 10-year or longer of biochemical and survival outcome for brachytherapy alone, and brachytherapy combined with supplemental external beam radiation therapy with emphasis on its impact on quality of life.