High dose rate or HDR brachytherapy treatments utilize radioactive materials that are placed temporarily in body tissues or cavities. These implants can be done with high intensity sources that oscillate within the radiation carrier and then are removed within minutes.
Hollow plastic tubes or catheters are placed in the area requiring treatment. The end of the catheter that is outside the tissue will be connected to a special machine. Once connected, the staff will leave the treatment room. They will be able to communicate with you through the intercom system and will be watching you at all times via the video monitor. The machine will then be activated remotely having small radioactive sources, which are located within another plastic ribbon or catheter, travel from the housing of the machine to the end of the catheter placed within the tissue or cavity.
Once the radioactive sources have been in place long enough to deliver the treatment dose (usually less than 15 minutes) they will travel back to the machine housing. The radiation dose is administered by the radioactive source that travels through the tube to the treatment area to deliver the radiation dose from inside the tissue or cavity to the immediately adjacent tissue. After the sources return to the machine, the staff will re-enter the room and verify the radioactive materials have all been removed. The machine is then disconnected from the end of the catheter. Once the radioactive material is removed, there will be no radioactivity remaining in your body.
In most cases, HDR brachytherapy treatments are done on an outpatient basis, but sometimes the placement of the hollow catheters or tubes (through which the radioactive sources will travel) is performed under anesthesia and requires a short hospital stay. This type of implant may be done once a week either during your external beam radiation or for several treatments at its conclusion. It can be used to treat a variety of cancers but is rarely the only radiation treatment prescribed.
The weekly sessions take approximately two to three hours and are repeated for a pre-determined number of sessions to achieve the desired radiation dose. In some instances, sedation will be used during the procedure to make it more comfortable. If this is the case, you will be asked to have someone drive you home.
The side effects of HDR brachytherapy are similar to those experienced with external beam radiation.