scholarly journals Interstitial High-Dose-Rate Brachytherapy of Liver Metastases in Oligometastatic Patients

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6250
Author(s):  
Franziska Walter ◽  
Maya Rottler ◽  
Lukas Nierer ◽  
Guillaume Landry ◽  
Justus Well ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Group Analysis ◽  
Oncologic Outcome ◽  
High Volume ◽  
Target Volume ◽  
Local Relapse ◽  
High Dose Rate ◽  
High Dose ◽  
Significant Difference ◽  
High Volume Center

Local ablative treatments have emerged as a promising treatment strategy for patients with oligometastatic disease. Among others, interstitial brachytherapy (iBT) is an upcoming treatment option for unresectable liver metastases. We report the feasibility and oncologic outcome of iBT of oligometastatic liver metastases performed in patients with limited tumor burdens in a high-volume center. Patients undergoing iBT between August 2017and March 2019 were included. A retrospective analysis of patient outcomes and treatment complications was performed. Patients treated for metastatic colorectal carcinoma (CRC) were compared to other histologies. A total of 141 iBT procedures were performed in 106 patients (male:52; female:54) and 244 liver metastases. Overall, 51% (54/106) of patients had a diagnosis of metastatic CRC. The median follow-up was 9 months, and overall survival (OS) was 92.3% at 6 months and 76.3% at 12 months. Local-relapse-free survival (LRFS) was 88.4% at 6 months and 71.5% at 12 months, with a significant difference between patients with CRC (84.1% and 50.6%) versus other histologies (92.4% and 92.4%, p < 0.001). A sub-group analysis showed a significant advantage in patients with CRC receiving a minimal dose (D100) of 20 Gy to the planning target volume. Treatments of smaller total liver-tumor volumes (<18 ccm) resulted in better LRFS rates. iBT is a safe and effective treatment approach for oligometastatic liver disease. A higher treatment dose is needed for patients with CRC. Moreover, lower metastatic burdens may be favorable for LRFS. Prospective studies are needed to assess the role of iBT in the oligometastatic setting as an alternative to other local ablative treatment approaches in patients with liver metastases.

scholarly journals Dosimetric Comparison between High Dose Rate Brachytherapy Boost and Volumetric Arc Therapy Boost in Locally Advanced Cancer Cervix

2021 ◽  
Vol 07 (02) ◽  
pp. 085-088
Author(s):  
Hanady Hegazy ◽  
Neamat Hegazy ◽  
Maher Soliman ◽  
Amr Elsaid
Keyword(s):  
Small Bowel ◽  
Dose Rate ◽  
Advanced Cancer ◽  
Locally Advanced ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Cancer Cervix ◽  
Arc Therapy ◽  
Locally Advanced Cancer

AbstractConcurrent chemoradiotherapy is considered the standard treatment for the locally advanced cancer cervix (LACC). Radiotherapy is commonly administered by a three-dimensional conformal radiotherapy (3DCRT) approach followed by brachytherapy (BT). High dose rate (HDR) BT is commonly administered; however, several drawbacks exist including invasive technique, pain, requirement of anesthesia, and operative risks. We assessed the dosimetric difference between the HDR BT and the volumetric modulated arc therapy (VMAT) boost in those patients. Ten patients were selected retrospectively with LACC and all received whole pelvis radiotherapy followed by BT boost of 7 Gy in three fractions. The computed tomography (CT) image was transferred to the Varian system for the VMAT plan while the one with the applicator was transferred to the Sagi planning system and the high-risk clinical target volume (HR-CTV), bladder, rectum, sigmoid, and small bowel were delineate with a margin of 5 mm were added to the CTV to create the planning target volume (PTV). The D90 for the PTV in VMAT boost was lower than received by the HR-CTV in the BT boost. Mean volume of the PTV was higher than that of the HR-CTV. The D2cc was higher in VMAT for bladder, sigmoid, and rectum while the D2cc for the small bowel in BT was higher compared with the VMAT. The VMAT is an option that exists for patients who refuse BT or cannot tolerate it, or in case of nonavailability of BT or a nonworking machine.

scholarly journals Interstitial HDR Brachytherapy in the Treatment of Non-Melanocytic Skin Cancers around the Eye

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1425
Author(s):  
Paweł Cisek ◽  
Dariusz Kieszko ◽  
Mateusz Bilski ◽  
Radomir Dębicki ◽  
Ewelina Grywalska ◽  
...  
Keyword(s):  
External Beam Radiotherapy ◽  
Late Complication ◽  
Target Volume ◽  
Lower Eyelid ◽  
High Dose Rate ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Lateral Canthus ◽  
Skin Cancers

Background: Eyelid tumors are rare skin cancers, the most common of which is basal cell carcinoma characterized primarily by local growth. In addition to surgery, radiotherapy is among the basic methods of treatment. External beam radiotherapy is associated with the risk of complications within ocular structures, especially the lens. In the case of interstitial brachytherapy, it is possible to administer a high dose to the clinical target volume (CTV), while reducing it in the most sensitive structures. Methods: This paper presents the results of an analysis of 28 patients treated with interstitial high dose rate (HDR) brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral canthus; and the cheek, nose and temples with the infiltration of ocular structures. The patients were treated according to two irradiation schedules: 49 Gy in 14 fractions of 3.5 Gy twice a day for 7 days of treatment, and 45 Gy in 5 Gy fractions twice a day for 5 days. The mean follow-up was 22 months (3–49 months). Results: two patients (6%) had a relapse: a local recurrence within the irradiated area in one of them, and metastases to lymph nodes in the other. The most common early complication was conjunctivitis (74%), and the most common late complication was dry eye syndrome (59%). Conclusions: Interstitial HDR brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral cants; and the cheek, nose and temples with infiltration of ocular structures is a highly effective, short and relatively low burden type of treatment.

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.

High-Dose Interstitial Brachytherapy for Glioblastoma Multiforme

1994 ◽  
Vol 80 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Enrico Micheletti ◽  
Giovanni Baroncelli ◽  
Beniamino La Face ◽  
Piero Feroldi ◽  
Marco Galelli ◽  
...  
Keyword(s):  
Glioblastoma Multiforme ◽  
Performance Status ◽  
Treatment Protocol ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Treatment Schedule ◽  
Ecog Performance Status ◽  
Short Treatment ◽  
Long Term Prognosis

Aims and background The long-term prognosis for survival of patients with inoperable glioblastoma multiforme (GBL) is very poor. Conventional external radiotherapy gives only transitory result. This severe prognosis led us to elaborate a high-dose rate (HDR), after-remote-loading brachytherapy treatment protocol: our aim was both therapeutic and psychologic Methods Five patients with GBL (T1 G4 UICC) were treated with stereotactic biopsy followed by HDR brachytherapy. A unique coaxial after-loading catheter was stereotactically inserted through the center of the target volume. The treatment schedule considered 5 fractions, 5 Gy/fraction at the dose specification surface, 2 fractions per day. Results The treatment was well tolerated. Tumor progression started again at the 8th to the 16th week from the end of the treatment. ECOG performance status at the 8th week was better than before the therapy in 2 of 5 patients and was stable in 2 of 5 patients. Order neuroperformance status was stable in 2 patients at 8 weeks. At the 16th week there was neurologic deterioration. The average survival was 21 weeks. Conclusions Our approach seems to be of some interest for the pal-lation of GBL, and it offers some advantages, in particular regarding the short treatment period. Our procedure can be improved: a multicatheter implant and a more fractionated schedule could be taken into account.

scholarly journals Toxicity Outcome Using Bladder-Rectum Spacer Balloon Versus Vaginal Gauze Packing in Brachytherapy in Cervical Cancer.

2021 ◽  
Author(s):  
Nagarjun Ballari ◽  
Sakshi Rana ◽  
Bhavana Rai ◽  
Srinivasa Gowda ◽  
Suja Bhargavan ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Randomized Study ◽  
High Dose Rate ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Clinical Trial Registry ◽  
Gauze Packing ◽  
Dosimetric Data ◽  
Significant Difference

Abstract BACKGROUNDTo compare the clinical impact in terms of toxicity outcomes with RayshieldTM bladder rectum spacer balloon (BRSB) versus vaginal gauze packing (VGP) in patients treated with high dose rate intracavitary brachytherapy for carcinoma cervix.RESULTSFollow-up and dosimetric data of patients in whom BRSB and VGP were used in a previously reported randomized study were retrieved, 8. Out of 80 patients analysed, late toxicities assessment (according to Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4). was possible in 65 patients as 14 patients were lost to follow-up and one patient died. Grade 2 bladder toxicity was observed in 2 patients in each arm. Only 1 patient in VGP arm experienced grade 3 proctitis while none of the patient in BRSB arm had ³Grade 2 rectal toxicity. Vaginal toxicity was comparable in both the arms.CONCLUSION No significant difference was observed in bladder and rectal toxicities using the BRSB versus VGP. BRSB can be considered as an alternative to VGP in intracavitary brachytherapy for cervical cancer using tandem- ovoid applicatorsThe study was approved by the institute ethics committee and registered under Clinical Trial Registry of India (CTRI/2009/091/000840).

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