Prostate brachytherapy is among several roughly comparable options for front line treatment of localized prostate cancer available at this time. Unfortunately, there had not been a comparative prospective trial comparing external radiation, seed implants, brachytherapy, robotic prostatectomy, nerve sparing prostatectomy or conventional prostatectomy, proton beam radiotherapy and hormonal manipulation. Look-back reviews of past studies show these options to be similarly effective. A 2008 research summary by the Agency for Healthcare Research and Quality (AHRQ) noted that no randomized controlled trials had compared brachytherapy with other major treatment options for clinically localized prostate cancer. Currently, brachytherapy is widely used but with external beam radiotherapy( EBRT) support. The reason for it is that brachytherapy delivers radiation over very small distances. It does not, for example, get enough radiation to the outer part of the prostate. EBRT treats the areas in which radiation distribution from brachytherapy is decreased. High dose approaches and combinations with other treatments may do what ERBT currently does. Whether some patients can avoid EBRT is being investigated.
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