Brachytherapy in the Management of Prostate Cancer Bradley J. Stish, MD a, *, Brian J. Davis, MD, PhD a , Lance A. Mynderse, MD b , Christopher L. Deufel, PhD a , Richard Choo, MD a INTRODUCTION In 2016, there will be an estimated 180,890 men with a new diagnosis of prostate can- cer, of whom approximately 80% will have localized disease, with an estimated 26,120 prostate-cancer specific deaths. Prostate cancer is the second leading cause of Disclosure State: Dr B.J. Stish, L.A. Mynderse, C.L. Deufel, and R. Choo have nothing to disclose. Dr B.J. Davis: Speaking honoraria from the American Brachytherapy Society, American College of Radiation Oncology, American Society Radiation Oncology, Prospect Medical Inc; Stock ownership; Pfizer Inc, Research grants from Takeda UK Inc, and a grant Augmenix; Travel ex- penses from American Board of Radiology. a Department of Radiation Oncology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; b Department of Urology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA * Corresponding author. E-mail address: stish.bradley@mayo.edu KEYWORDS  Prostate cancer  High dose rate brachytherapy  Low dose rate brachytherapy  Radiation therapy  Image guidance  Dose escalation KEY POINTS  Brachytherapy is an important tool for radiation oncologists in the curative management of men with all risk categories of localized prostate cancer.  By delivering radiation directly to the prostate gland via implantation, brachytherapy al- lows clinicians to deliver significant radiation dose escalation while minimizing doses to nearby normal tissues.  Both low dose rate and high dose rate brachytherapy have published long-term data sup- porting their use for the treatment of prostate cancer.  The long-term safety and tolerability of brachytherapy has been reported in multiple trials and series.  Outcomes with brachytherapy compare favorably with other definitive treatment modalities. Surg Oncol Clin N Am - (2017) -–- http://dx.doi.org/10.1016/j.soc.2017.01.008 surgonc.theclinics.com 1055-3207/17/ª 2017 Elsevier Inc. All rights reserved.