Demanes started using HDR in 1981. For 10 years he used both HDR and permanent seed brachytherapy. Based on his comparative results of the two procedures he has only used HDR since 1991. HDR is also used for many different cancers.
It isn't well known because over the last 15 years more attention was given to permanent seed brachytherapy. In some areas rad-oncs have been using HDR and it is growing. I am in Atlanta and one hospital uses HDR and my rad-onc practice has two people that do HDR. Together they are performing 8-10 procedures per week. My rad-onc is the junior and he and my urologist have done well over 1,000 procedures. I understand that the hospital also does about a dozen procedures per week.
In Atlanta we also have the nation's preeminent permanent seed brachytherapy clinic headed by the doctor that pioneered the delivery of seed brachytherapy combined with IMRT concurently. Thus we have a lot of radiology options.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011