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High Dose Rate Brachytherapy (HDR-B) is a form of internal radiation therapy where a high-strength radioactive source is temporarily placed directly into or near the tumor site using catheters or needles. In the specific protocol developed by The Methodist Hospital Research Institute (NEOHDR-B), a single 15Gy fraction of HDR-B is administered neoadjuvantly to patients with localized high-risk prostate cancer approximately 4 to 8 weeks prior to robotic-assisted laparoscopic prostatectomy (RALP). This neoadjuvant approach is designed to provide intense local radiation to the prostate to improve surgical outcomes and local control. The treatment is often followed by selective adjuvant androgen blockade based on genomic risk or nodal status.
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