Using Endoscopic Optical Coherence Tomography to Detect and Treat Early-Stage Pancreatic Cancers

We developed a novel technology capable of detecting early-stage pancreatic cancers using high-resolution three-dimensional endoscopic optical coherence tomography (Endo-OCT), and treating them using high dose rate brachytherapy (HDR) under the Endo-OCT image guidance. This technology integrates our custom-built ultra-high resolution endoscopic three-dimensional OCT diagnostic imaging device with a commercial high dose rate brachytherapy system (HDR), resulting in a compact, portable, easy-to-operate, and low-cost Endo-OCT image-guided high dose rate brachytherapy (OCT-IGHDR) system. The system has the dual functions of diagnosis and treatment that can precisely detect and measure the location and size of the early-stage pancreatic cancer or premalignant lesions and then treat them from the inside of the pancreatic duct with an accurate and focused dose while greatly reducing the radiation toxicity to the neighboring tissues and organs. This minimally-invasive treatment technology could avoid the potential complications from surgery and reduces the high operation cost. This technology could also be applied to treat diseases of the esophagus, rectum, bronchus, and other aerodigestive organs that are suitable for use with an endoscopic device. In this article, we describe the concept of this technology and the preliminary experiments that could demonstrate the concept by using this homemade Endo-OCT machine to image the pancreatic duct for diagnosis of early-stage pancreatic cancer or premalignant lesions and to perform Endo-OCT image-guided brachytherapy.

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76 oral INTERSTITIAL HIGH DOSE RATE BRACHYTHERAPY FOR EARLY STAGE BREAST CANCER : MEDIAN 6 YEAR FOLLOW-UP OF 280 CASES USING MULTI-CATHETER TECHNIQUE

Radiotherapy and Oncology ◽

10.1016/s0167-8140(11)70199-2 ◽

2011 ◽

Vol 99 ◽

pp. S29

Author(s):

R. Lawrence ◽

R. Mark

Keyword(s):

Breast Cancer ◽

Dose Rate ◽

Early Stage ◽

High Dose Rate ◽

Early Stage Breast Cancer ◽

High Dose ◽

High Dose Rate Brachytherapy ◽

Catheter Technique

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Interstitial high-dose-rate brachytherapy as monotherapy for early stage prostate cancer

Brachytherapy ◽

10.1016/j.brachy.2008.02.455 ◽

2008 ◽

Vol 7 (2) ◽

pp. 181

Author(s):

Rufus J. Mark ◽

Paul J. Anderson ◽

Robin S. Akins ◽

Murali Nair

Keyword(s):

Prostate Cancer ◽

Dose Rate ◽

Early Stage ◽

High Dose Rate ◽

High Dose ◽

High Dose Rate Brachytherapy

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High-dose-rate brachytherapy for vaginal cancer: Learning from treatment complications

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200201000-00005 ◽

2002 ◽

Vol 12 (1) ◽

pp. 27-31

Author(s):

W. C Tyree ◽

H Cardenes ◽

M Randall ◽

L Papiez

Keyword(s):

Dose Rate ◽

Late Effects ◽

Early Stage ◽

High Dose Rate ◽

Vaginal Cancer ◽

High Dose ◽

Hdr Brachytherapy ◽

High Dose Rate Brachytherapy ◽

Treatment Complications ◽

Treatment Plans

Abstract.Tyree WC, Cardenes H, Randall M, Papiez L. High-dose-rate brachytherapy for vaginal cancer: learning from treatment complications.Historically, early stage vaginal cancer has been treated with low-dose-rate (LDR) brachytherapy with or without external beam radiation therapy (EBRT). Complication rates have been low and treatment efficacious. Although high-dose-rate (HDR) brachytherapy has been used for cervical cancer in many countries for over a decade, only more recently has it been integrated into treatment plans for vaginal cancer. This paper describes three patients treated with HDR brachytherapy who experienced significant late effects. Given the very limited amount of literature regarding the use of HDR brachytherapy in vaginal cancer, this analysis potentially contributes to an understanding of treatment-related risk factors for complications among patients treated with this modality.A focused review of hospital and departmental treatment records was done on three patients treated with HDR brachytherapy. Abstracted information included clinical data, treatment parameters (technique, doses, volume, combinations with other treatments) and outcomes (local control, survival, early and late effects). A review of the available literature was also undertaken.All patients had significant complications. Although statistical correlations between treatment parameters and complications are impossible given the limited number of patients, this descriptive analysis suggests that vaginal length treated with HDR brachytherapy is a risk factor for early and late effects, that the distal vagina has a lower radiation tolerance than the upper vagina with HDR as in LDR, and that combining HDR with LDR as done in our experience carries a high risk of late toxicity.Integration of HDR brachytherapy techniques into treatment plans for early stage vaginal cancers must be done cautiously. The etiology of the significant side effects seen here is likely to be multifactorial. For users of HDR brachytherapy in vaginal cancer, there is a need to further refine and standardize treatment concepts and treatment delivery. Ideally this will be based on continued careful observation and reporting of both favorable and unfavorable outcomes and experiences.

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