Table 2.

Clinical cases which could benefit from brachytherapy.

No.	Diagnosis	Therapy	Evolution
Tumors locate in the prostate
1	Prostate adenocarcinoma T3NoMo, G8,iPSA = 18 ng/mL (2013)	Hormone therapy (HT) + External radiotherapy (RT) 76 Gy	Local recurrence. A complement of brachytherapy seeds in 2013 could have avoided the recurrence.
2	Prostate adenocarcinoma T2NoMo, G6, iPSA = 11 ng/mL (2011). Right seminal bladder recurrence	Permanent implant of iodine 125	Local recurrence. A complement of brachytherapy seeds would avoid a mutilating surgery that the patient refused.
3	Prostate adenocarcinoma T2aNoMo, G6, iPSA = 9 (2012). Prior rectum cancer surgically removed	Hormone therapy (HT)	Death. Robotic brachytherapy would have saved the patient.
4	Bladder cancer, T2NoMo	Radical cystectomy	Partial cystectomy and robotic brachytherapy would have avoided the mutilating surgery with a better quality of life.
Tumours located in the liver
1	Rectosigmoid cancer stage IV (liver and pulmonary metastases), Radio- and Chemotherapy (RCT), surgery	Palliative chemotherapy. Radiofrequency ablation	Focal brachytherapy would have performed better on the liver metastases.
2	Oesophagus cancer, stage III, RCT. Local recurrence and liver spread. Cirrhosis	Supportive care	Death. Brachytherapy (oesophagus and liver) would have extended the patient survival with good life quality.
3	Unifocal hepatocellular carcinoma over cirrhosis. Inoperable due to comorbidities	Sorafenib	Death. Local brachytherapy would have extended the patient survival.
Tumours located at the rectum level
1	Rectal cancer, RCT, surgery. Local recurrence	Palliative chemotherapy	Local and distant recurrence. Brachytherapy would have improved the prognosis avoiding (or delaying) metastases.
2	Rectum (stage III) and prostate Synchronous Adenocarcinoma T3NoMo	RCT + surgery	Prostate brachytherapy would have prevented the surgery and all its complications (incontinence, urinary infection).
3	Epidermoid carcinoma anal canal. T4N2Mo, RCT. Local recurrence. Surgery (rectum amputation)	Surgery	Initial brachytherapy would have avoided the recurrence and thus the amputation.
4	Inferior rectum adenocarcinoma T2NoMo	Rectum amputation	Local excision and brachytherapy would have avoided the second, mutilating, surgery.
Thoracic tumours (lungs and breast)
1	Pulmonary metastases following testicle cancer, multiple recurrences	Chemotherapy, surgeries (testicle, ganglions, lungs) External pulmonary radiotherapy	Death. Brachytherapy would have avoided the recurrences.
2	Epidermoid pulmonary cancer. Local inoperable recurrence	Chemotherapy, palliative radiotherapy	Death. Brachytherapy would have, at least, extended the survival.
3	Thoracic sarcoma	Surgery, radiotherapy	Brachytherapy would have provided the same outcome with much lower toxicity.
4	Retroperitoneal sarcoma, positive margins resection, irradiated	Surgery, RT, CHT	Local recurrence. Brachytherapy could have complemented the external dose of radiation to avoid recurrences, without the increase in intestinal toxicity.