ABSTRACT
This chapter outlines competing techniques for the treatment of cervical, endometrial, prostate, breast, and rectal cancer, and discusses the recent utilization and trend of brachytherapy compared to external beam radiotherapy (EBRT). The standard of care for the curative management of locally advanced cervical cancer consists of EBRT, concurrent chemotherapy, and brachytherapy. Brachytherapy is an essential component of the treatment that enables the most conformal dose escalation to the primary tumor. A planning study comparing brachytherapy versus intensity-modulated radiotherapy (IMRT) and intensity-modulated proton therapy (IMPT) showed that brachytherapy was superior to IMRT and IMPT in target doses and organ at risk (OAR) sparing. Endometrial cancer is surgically staged. Intermediate, high-intermediate, and high-risk disease are treated with adjuvant radiotherapy. For low- and intermediate-risk prostate cancer, definitive treatment options include radical prostatectomy (RP), EBRT, or brachytherapy, all of which have comparable outcomes. Brachytherapy is more cost effective compared to RP and EBRT.
