Brachytherapy (HDR & LDR)

Brachytherapy is a method of delivering radiation to tumors by placing radioactive sources either within or immediately adjacent to tumor tissue. Because the radiation source is very close to the tumor, radiation can go directly to the tumor without traveling through normal tissue. Brachytherapy can be given by low dose rate (link) or high dose rate (link) techniques, depending on the length of time the radioactive sources remain in place.

At UCSF, we use a team approach to care for our brachytherpay patients. The brachytherapy team includes a radiation oncologist, surgeon, physicist, radiation therapist, and nurse. Our excellent staff members work together to provide the best care possible. We offer brachytherapy for a variety of body sites including central nervous system, head and neck, lung, genitourinary, gynecologic, and other soft tissue tumors. A wide range of specialized applicators and modern treatment planning allow us to provide the most comprehensive brachytherapy program in California.

Low Dose Rate (LDR) Brachytherapy

With low dose rate brachytherapy, the radioactive sources are positioned inside or immediately adjacent to the tumor for a minimum of several days but may be left in the tissue permanently. At UCSF, low dose rate brachytherapy is most commonly used to treat prostate cancer and brain tumors.

Permanent prostate seed implants have been done at UCSF since 1995. Many patients with prostate cancer are candidates for this curative procedure. The urologist and radiation oncologist perform the implant together in the operating room. Most patients go home later that day.

Central nervous system brachytherapy for brain metastases and other brain tumors has been done at UCSF for over 25 years. Radioactive seeds are placed at the time of craniotomy for tumor removal. The neurosurgeon and radiation oncologist work together to place the seeds.

High Dose Rate (HDR) Brachytherapy

During HDR brachytherapy a single radioactive source is temporarily placed in the tumor volume, requiring just a few minutes, and then removed. The source travels inside small plastic catheters controled by a machine called a remote afterloader. Since the source position can be precisely adjusted, we can create customized dose distributions to meet each patient's needs. HDR brachytherapy is most commonly used to treat prostate, cervical, and head and neck cancer; although, the flexibility of our HDR system allows us to use this technology for a wide range of malignancies.

UCSF has a dedicated team of experts in HDR brachytherapy. Recent technological advances at UCSF have led to significant breakthroughs in the delivery of HDR brachytherapy. We routinely use CT and MR image guidance and inverse planning to create the optimal dose distribution. This convergence of innovative HDR brachytherapy technology and clinical expertise is only available at UCSF.

Brachytherapy Team

Adam Cunha, PhD
Alexander Gottschalk, MD
Joe Hsu, MD
Jean Pouliot, PhD
Mack Roach, MD
Penny Sneed, MD