Role of brachytherapy with permanent implants in organ-confined prostate cancer

Advances in brachytherapy with transperineally applied permanent implants i n organ-confined prostate cancer are discussed controversially ever more fr equently. In a literature review, the innovations in treatment planning and implant technique as well as the treatment results and morbidity were anal ysed. Transperineal brachytherapy with permanent implants presents a minima l invasive therapeutic concept with minor morbidity and low progression rat es. However, by interpreting the results, it should be taken into account, that they are based on a number of preselected patients presenting low PSA values, highly differentiated carcinoma as well as incidental or clinically small volume tumors. The data do not justify this therapy to be an equival ent alternative to radical prostatectomy. Based on a strict indication rega rding pretreatment prognostic factors for therapeutic outcome, prospective studies are required for a definitive evaluation of the role of brachythera py in prostate cancer.