Inter-fraction variation in interstitial high-dose-rate brachytherapy

2015 ◽  
Vol 14 (2) ◽  
pp. 143-151 ◽  
Author(s):  
Saravanan Kandasamy ◽  
K. S. Reddy ◽  
Vivekanandan Nagarajan ◽  
Parthasarathy Vedasoundaram ◽  
Gunaseelan Karunanidhi
Keyword(s):  
Ct Scan ◽  
Dose Rate ◽  
Organs At Risk ◽  
Breast Implant ◽  
Quality Care ◽  
Significant Risk ◽  
Tumour Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy

AbstractAimTo evaluate the inter-fraction variation in interstitial high-dose-rate (HDR) brachytherapy. To assess the positional displacement of catheters during the fractions and the resultant impact on dosimetry.BackgroundAlthough brachytherapy continues to be a key cornerstone of cancer care, it is clear that treatment innovations are needed to build on this success and ensure that brachytherapy continues to provide quality care for patients. The dosimetric advantages offered by HDR brachytherapy to the tumour volume rely on catheter positions being accurately reproduced for all fractions of treatment.Materials and methodsA total of 66 patients treated over a period of 22 months were considered for this study. All the patients underwent computer tomography (CT) scan and three-dimensional treatment planning was carried out. Brachytherapy treatment was delivered by the HDR afterloading system. On completing the last fraction, CT scan was repeated and treatment re-planning was done. The variation in position of the implanted applicators and their impact on dosimetric parameters were analysed using both the plans.ResultsFor all breast-implant patients, the catheter displacement and D90dose to clinical target volume were <3 mm and 3%, respectively. The displacement for carcinoma of the tongue, carcinoma of the buccal mucosa, carcinoma of the floor of mouth, carcinoma of the cervix, soft-tissue sarcoma and carcinoma of the lip were comparatively high.ConclusionInter-fraction errors occur frequently in interstitial HDR brachytherapy. If no action is taken, it will result in a significant risk of geometrical miss and overdose to the organs at risk. It is not recommended to use a single plan to deliver all the fractions. Imaging is recommended before each fraction and decision on re-planning must be taken.

The role of needle trauma to the neurovascular bundle region (NVB) and its impact on potency following high-dose-rate (HDR) brachytherapy

Brachytherapy ◽  
2007 ◽  
Vol 6 (2) ◽  
pp. 86
Author(s):  
Michel I. Ghilezan ◽  
J. Vito Antonucci ◽  
Gary S. Gustafson ◽  
Peter Chen ◽  
Michelle Wallace ◽  
...  
Keyword(s):  
Dose Rate ◽  
High Dose Rate ◽  
Neurovascular Bundle ◽  
High Dose ◽  
Hdr Brachytherapy

Interstitial High Dose Rate (HDR) Brachytherapy for Early Stage Breast Cancer: A Report of 136 Cases

2007 ◽  
Vol 69 (3) ◽  
pp. S229 ◽  
Author(s):  
P.J. Anderson ◽  
R.J. Mark ◽  
R.S. Akins ◽  
T.R. Neumann ◽  
S. Gurley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dose Rate ◽  
Early Stage ◽  
High Dose Rate ◽  
Early Stage Breast Cancer ◽  
High Dose ◽  
Hdr Brachytherapy

Cholangiocarcinoma: The impact of endobiliary high-dose-rate (HDR) brachytherapy dose response on survival

Brachytherapy ◽  
2006 ◽  
Vol 5 (2) ◽  
pp. 91
Author(s):  
Matthew Biagioli ◽  
B-Chen Wen ◽  
Brandon Patton ◽  
Caroline Hoffman ◽  
Mark Harvey
Keyword(s):  
Dose Rate ◽  
Dose Response ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
The Impact

scholarly journals Implementation of High Dose Rate Brachytherapy in Cancer Treatment

2021 ◽  
Vol 1 (3) ◽  
pp. 77-106
Author(s):  
Amir Shahabaz ◽  
Muhammad Afzal
Keyword(s):  
Radiation Therapy ◽  
Side Effects ◽  
Dose Rate ◽  
Radiation Source ◽  
Cancer Recurrence ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Short Treatment ◽  
High Dose Rate Brachytherapy

A technique of radiation therapy delivery in which the radioactive sources are placed very close or even inside the target volume is called Brachytherapy (BT). Brachytherapy is a type of radiation therapy. It destroys cancer cells by making it hard for them to multiply. In this technique, a radiation source is placed directly into or near a tumour. High dose-rate brachytherapy is also known as HDR brachytherapy, or temporary brachytherapy. It is a type of internal radiotherapy. HDR was developed to reduce the risk of cancer recurrence while shortening the amount of time it takes to get radiation treatment. HDR also limits the dose of radiation (associated side effects) to surrounding normal tissue. The important benefits of HDR brachytherapy include extremely precise radiation therapy delivered internally, used alone or after surgery to help prevent cancer recurrence, convenient treatments that are usually pain-free, and a reduction in the risk of common short- and long-term side effects. Currently, tumour dose, as well as doses of the surrounding normal structures, can be evaluated accurately, and high-dose-rate brachytherapy enables three-dimensional image guidance. The biological disadvantages of high-dose-rate were overcome by fractional irradiation. In the definitive radiation therapy of cervical cancer, high-dose-rate brachytherapy is most necessary. Most patients feel little discomfort during brachytherapy. There is no residual radioactivity when the treatment is completed. A patient may be able to go home shortly after the procedure, resuming his normal activities with few restrictions. An advantage of brachytherapy is to deliver a high dose to the tumour during treatment and save the surrounding normal tissues. High-dose-rate (HDR) brachytherapy has great promise with respect to proper case selection and delivery technique because it eliminates radiation exposure, can be performed on an outpatient basis and allows short treatment times. Additionally, by varying the dwell time at each dwell position, the use of a single-stepping source allows optimization of dose distribution. As the short treatment times do not allow any time for correction of errors, and mistakes can result in harm to patients, so the treatments must be executed carefully by using HDR brachytherapy. Refinements will occur primarily in the integration of imaging (computed tomography, magnetic resonance imaging, intraoperative ultrasonography) and optimization of dose distribution and it is expected that the use of HDR brachytherapy will greatly expand over the next decade. Various factors in the development of well-controlled randomized trials addressing issues of efficacy, quality of life, toxicity and costs-versus-benefits will ultimately define the role of HDR brachytherapy in the therapeutic armamentarium. Surrounding healthy tissues are not affected by the radiation due to the ability to target radiation therapy at high dose rates directly to the tumour. Treatment to be delivered as an outpatient in as few as one to five sessions is also allowed by this targeted high dose approach. HDR brachytherapy is the most precision radiation therapy, even better than carbon ion therapy. At the time of invasive placement of the radiation source into the tumour area, brachytherapy requires the skills and techniques of radiation oncologists.

Dosimetric evaluation of tandem-based cervical high-dose-rate brachytherapy treatment planning using American Brachytherapy Society 2011 recommendations

2016 ◽  
Vol 15 (3) ◽  
pp. 283-289 ◽  
Author(s):  
Manish K. Goyal ◽  
T. S. Kehwar ◽  
Jayanand Manjhi ◽  
Jerry L. Barker ◽  
Bret H. Heintz ◽  
...  
Keyword(s):  
Linear Regression ◽  
Dose Rate ◽  
Regression Line ◽  
High Dose Rate ◽  
Least Square ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Linear Regression Line ◽  
Significant Difference ◽  
Best Fit

AbstractPurposeThis study evaluated dosimetric parameters for cervical high-dose-rate (HDR) brachytherapy treatment using varying dose prescription methods.MethodsThis study includes 125 tandem-based cervical HDR brachytherapy treatment plans of 25 patients who received HDR brachytherapy. Delineation of high-risk clinical target volumes (HR-CTVs) and organ at risk were done on original computed tomographic images. The dose prescription point was defined as per International Commission in Radiation Units and Measurements Report Number 38 (ICRU-38), also redefined using American Brachytherapy Society (ABS) 2011 criteria. The coverage index (V100) for each HR-CTV was calculated using dose volume histogram parameters. A plot between HR-CTV and V100was plotted using the best-fit linear regression line (least-square fit analysis).ResultsMean prescribed dose to ICRU-38 Point A was 590·47±28·65 cGy, and to ABS Point A was 593·35±30·42 cGy. There was no statistically significant difference between planned ICRU-38 and calculated ABS Point A doses (p=0·23). The plot between HR-CTV and V100is well defined by the best-fit linear regression line with a correlation coefficient of 0·9519.ConclusionFor cervical HDR brachytherapy, dose prescription to an arbitrarily defined point (e.g., Point A) does not provide consistent coverage of HR-CTV. The difference in coverage between two dose prescription approaches increases with increasing CTV. Our ongoing work evaluates the dosimetric consequences of volumetric dose prescription approaches for these patients.

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