Brachytherapy treatment apparatus are provided that include an elongate core member, a plurality of expandable catheters or other elongate members and a balloon or other expandable member on a distal portion adjacent the core member. Each catheter includes a distal end coupled to the core member distal end, a proximal end movable relative to the core member, and a lumen extending between the proximal and distal ends for receiving a source of radiation therealong. The balloon is expandable independently of the catheters such that the balloon may be expanded after expanding the catheters, e.g., to facilitate imaging and/or dose planning. Optionally, a working channel may be provided for receiving an aspiration catheter or other instrument or at least one of the catheters may include an aspiration lumen and one or more ports, e.g., for aspirating material from a region surrounding the distal portion.
