The American Society of Clinical Oncology and Cancer Care Ontario have jointly updated a guideline on brachytherapy for patients with prostate cancer. Among the recommendations:

• Offer low-dose rate (LDR) brachytherapy alone, external beam radiation therapy (EBRT) alone, and/or radical prostatectomy to eligible patients with low-risk prostate cancer who require or choose active treatment.
• Offer brachytherapy boost (LDR or high-dose rate [HDR]) to eligible patients with intermediate-risk prostate cancer choosing EBRT with or without androgen-deprivation therapy.
• Offer LDR brachytherapy as monotherapy for low-intermediate risk prostate cancer.
• Offer LDR or HDR brachytherapy boost to eligible patients with high-risk prostate cancer receiving EBRT and androgen-deprivation therapy.
• It is reasonable to offer iodine-125 and palladium-103 for patients receiving LDR brachytherapy.
• No recommendation can be made for or against using cesium-131 or HDR monotherapy.