Brachytherapy Following External Beam Radiation Therapy

The use of radioactive seed implantation after external beam radiation therapy has five-year disease-free rates around 50%. Because this approach delivers radiation to very localized areas, it is not an optimal treatment for men with tumors that have spread beyond the prostate. Studies to date have indicated that men with low pre-therapy PSA levels and low Gleason scores will likely do well, whereas those with more distant disease and short PSA doubling times fare worse.

As with brachytherapy used as a primary therapy, side effects tend to be less frequent and less severe compared with other therapies. However, some studies have found urinary incontinence rates of up to 25-50% in men undergoing “salvage” brachytherapy, so careful consideration of existing urinary function and expected loss of function should be discussed fully with your doctors before any decision is made.

Terms to know from this article:

External beam radiation

A form of radiation therapy in which the radiation is delivered by a machine pointed at the area to be radiated. May be known as external beam radiation (EBR, XBR), external beam radiation therapy (EBRT, XBRT).


Gleason Score (GS) - Gleason Grade: A system of grading prostate cancer cells based on how they look under a microscope. Gleason scores range from 2 to 10 and indicate how likely it is that a tumor will spread. A low Gleason score means the cancer cells are similar to normal prostate cells and are less likely to spread; a high Gleason score means the cancer cells are very different from normal and are more likely to spread.


A procedure in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called internal radiation, implant radiation, or interstitial radiation therapy.


Inability to control the flow of urine from the bladder (urinary incontinence) or the escape of stool from the rectum (fecal incontinence).


prostate-specific antigen (PSA): A substance produced by the prostate that may be found in an increased amount in the blood of men who have prostate cancer, benign prostatic hyperplasia, or infection or inflammation of the prostate.