Journal of Contemporary Brachytherapy

PURPOSE: The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment. MATERIAL AND METHODS: A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software...

Radiation retinopathy (RR) and radiation maculopathy (RM) can occur as a result of uveal melanoma radiation treatment and after irradiation of other head and neck extraocular tumors, even with precise targeting techniques, such as stereotactic or proton beam radiotherapy. This review provides an overview of the current understanding of potential radiation damage to ocular tissues, and how recent developments in ophthalmic multimodal imaging techniques and treatment modalities have improved managing options...

PURPOSE: We aimed to assess the toxicity profile and clinical outcome in patients with locally advanced cervical cancer (LACC) treated with a combination of image-guided intensity-modulated radiation therapy (IG-IMRT) and image-guided brachytherapy (IGBT). MATERIAL AND METHODS: 25 LACC patients were recruited in this single-arm prospective study. Whole pelvis IG-IMRT was delivered (45 Gy with simultaneously integrated nodal boost of 55 Gy in 25 fractions), with concurrent weekly cisplatin (40 mg/m2 )...

PURPOSE: To explore differences in dosimetry and planning parameters between intra-cavitary/interstitial interpolation (IC + ISBT) three-dimensional (3D)-printed template-based (3D-printed) and simple intra-cavity (ICBT) radiation techniques using a fixed Rotterdam three-tube applicator (TT) for computed tomography-guided high-dose-rate brachytherapy in locally advanced cervical cancer. MATERIAL AND METHODS: This retrospective study included 100 patients ( n = 50 each in 3D-printed and Rotterdam three-tube applicator treatment groups) with FIGO stages IIB-IVB cervical cancer from May 2019 to May 2022...

PURPOSE: This study investigated reliable vaginal mucosa dose-volume histogram (DVH) metrics in gynecologic template interstitial high-dose-rate brachytherapy (HDR-BT) for the purpose of standardized dose reporting. MATERIAL AND METHODS: Gynecologic template (Syed/Neblett) interstitial HDR-BT patients treated from September 2016 to November 2022 at the study institute were included in the cohort. Each patient implant included a vaginal mucosa contour defined by a 5 mm expansion from vaginal cylinder, then another volume with clinical target volume subtracted...

The purpose of this report is to present the first documented application of GammaTile to an intra-cranial tumor of a patient with a symptomatic radiosensitive connective tissue disorder, a case where there were significant concerns with standard oncologic strategies. We hypothesized that GammaTile® (GT Medical Technologies, Tempe, Arizona, USA) would also be advantageous in the application of intra-cranial tumors in patients with conditions of increased radiosensitivity. We generated a standard external beam radiation therapy (EBRT) plan consisting of an overall 1...

PURPOSE: The aim of this study was to analyze the course of visual acuity (VA) in visual outcomes of patients treated with iodine-125 (125 I) brachytherapy in our center, based on original VA before treatment. MATERIAL AND METHODS: Visual acuity was prospectively assessed using a case series of 305 patients treated with 125 I between 1996 and 2022. To examine how VA behaves over time, we divided patient sample into 4 groups: (1) Patients with visual acuity of less than V ≤ 0...

PURPOSE: The study aimed to review the long-term outcomes of ruthenium brachytherapy for iris and iridociliary melanoma. MATERIAL AND METHODS: Medical records of patients who underwent ruthenium plaque treatment for iris and iridociliary melanoma at the Department of Ophthalmology, Poznań University of Medical Sciences, between 1999 and 2021 were retrospectively reviewed. RESULTS: We identified 24 patients, including 17 women and 7 men, with a median age of 61...

PURPOSE: To determine the dosimetric impact of brachytherapy applicator displacement during intracavitary (IC) and combined intracavitary/interstitial (IC/IS) high-dose-rate brachytherapy in the treatment of cervical cancer. MATERIAL AND METHODS: Data from 27 consecutively treated patients undergoing IC or IC/IS high-dose-rate brachytherapy with tandem and ovoid-based applicators at a single academic medical center were analyzed. Virtual applicator displacements (a single shift of whole applicator with tandem/ovoid/associated needles) of 0 (clinical position), 2, 5, 7, and 10 mm in the inferior direction were modeled on treatment planning CT or MRI scans, with maintaining the same dwell times...

PURPOSE: Nasopharyngeal cancers (NPC) are very aggressive, and the recurrence rate after radical therapy is high. This study aimed to evaluate the efficacy of brachytherapy (BT) also called interventional radiotherapy (IRT) in primary NPC in comparison with external beam radiotherapy (EBRT) alone. MATERIAL AND METHODS: A systematic search was performed in Scopus, Cochrane, and PubMed databases. Clinical query based on PICO framework was as follows: In patients with NPC (P), is EBRT plus IRT (I) superior to EBRT alone (C) in terms of local control (LC) and toxicity (O)? Full articles evaluating the efficacy of IRT as a boost after EBRT in patients with NPC were considered...

PURPOSE: Several cases of inaccurate irradiation in brachytherapy have been reported, occurring similarly to external radiation. Due to a large dose per fraction in brachytherapy, inaccurate irradiation can seriously harm a patient. Although various studies have been conducted, systems that detect inaccurate irradiation in brachytherapy are not as developed as those for external irradiation. This study aimed to construct a system that analyzes the source dwell position during irradiation using computed tomography (CT) scout images...

PURPOSE: Endometrial cancer is characterized as histopathological, molecular, genetic, biological, and very diverse group of malignancies. Due to the need to precisely define the indications for adjuvant treatment in recent years, there has been a division made according to risk groups based on prognostic factors, which identify patients at risk for disease relapse, who may benefit from adjuvant therapy. The aim of this research was to examine the clinical and morphological factors that influence disease-free survival (DFS) and overall survival (OS) in patients with FIGO IA stage endometrial cancer...

Few cases of patients with Cheng's type III portal vein tumor thrombus (PVTT) have been reported to achieve radical cure without recurrence over time. In this study, we reported on a 55-year-old male patient with a diagnosis of stage IIIa China liver cancer staging (CNLC), PVTT Cheng's type III, mild cirrhosis, and chronic viral hepatitis B. TACE combined with radioactive iodine-125 (125 I) particle implantation was applied to achieve radical treatment with sequential oral anlotinib hydrochloride capsules. This case might serve as a reference for the treatment of this disease...

PURPOSE: The prevalence of non-melanoma skin cancer (NMSC) increases, especially in older adults with comorbidities, narrowing radical treatment options. About 5% of skin cancer patients are diagnosed with an advanced stage, which impairs daily functioning. The study was to present a retrospective summary of elderly patients unfit for surgery and treated with various brachytherapy (BT) techniques tailored individually for locally advanced NMSCs in a reference BT department. Clinical case presentations supported the findings...

PURPOSE: Interstitial brachytherapy (ISBT) is indicated for intact cervical carcinoma (IN-CC) if intracavitary brachytherapy (ICRT) is not feasible and also in vault carcinoma (VA-C). We aimed to evaluate the doses to pelvic lymph node regions in IN-CC and VA-C treated with ISBT. MATERIAL AND METHODS: Ten patients (6 IN-CC, 4 VA-C) were chosen for this dosimetric study. IN-CC had a central tandem in addition to the needles. External iliac (EI-N), internal iliac (II-N), obturator (OB-N) and sacral (SA-N) groups of lymph nodes were delineated...

Simulators have revolutionized medical education and training across various disciplines, offering unique advantages in skill acquisition and performance improvement. In the context of interventional radiation therapy (IRT), simulators have emerged as valuable tools for training healthcare professionals in these complex procedures. This narrative review summarized the available evidence on the use of simulators in IRT training, highlighting their impact on proficiency, engagement, and self-confidence as well as their benefits for medical physicists and radiation therapists...

PURPOSE: Rectal complications in radiotherapy for cervical cancer can highly affect quality of life and correlate with rectal dose. Vaginal gauze packing (VP) and rectal retraction (RR) are widely used for rectal dose reduction in high-dose-rate brachytherapy. We aimed to perform a dosimetric comparison of these two methods for three-dimensional image-guided adaptive brachytherapy. MATERIAL AND METHODS: We retrospectively examined 50 patients with cervical cancer treated with definitive radiotherapy, including intra-cavitary brachytherapy, performed with VP and RR...

PURPOSE: Cervical stump cancer is a carcinoma that grows on the cervical stump after a sub-total hysterectomy. There have been no studies on the application of 3D brachytherapy in cervical stump cancer. In the present study, we aimed to compare the curative effects, toxicity, and dosimetry of 3D and 2D brachytherapy in cervical stump cancer. MATERIAL AND METHODS: Thirty-one patients admitted between 2012 and 2021, who were concurrently treated with intensity-modulated radiation therapy and brachytherapy for cervical stump cancer were divided into three groups according to the brachytherapy techniques: 2D brachytherapy, 3D image-guided brachytherapy (3D-IGBT), and 2D + 3D...

PURPOSE: To report outcomes of using image-guided hybrid intra-cavitary/interstitial applicators under moderate sedation for locally advanced cervical cancer patients in our institution. MATERIAL AND METHODS: A total of 69 fractions of brachytherapy with hybrid applicators were performed in 33 patients from January 2017 to April 2021. All patients underwent MRI pelvis 1 week pre-brachytherapy to determine suitability for interstitial brachytherapy and pre-plan needle placement...

PURPOSE: Delineation is a critical and challenging step in radiotherapy planning. Differences in delineation among observers are common, despite the presence of contouring guidelines. This study aimed to identify the inter-observer variability in the target volume delineation of computed tomography (CT)-guided brachytherapy for cervical cancer. MATERIAL AND METHODS: Four radiation oncologists (ROs) with different expertise levels delineated high-risk (HR) and intermediate-risk (IR) clinical target volume (CTV) according to GYN GEC-ESTRO recommendations, in a blinded manner on every CT set of ten locally advanced cervical cancer cases...