Journal of Contemporary Brachytherapy最新文献

{"title":"Prostate brachytherapy boost: Long-term results of protocol-based treatment of patients with non-metastatic prostate cancer.","authors":"Claudia Schweizer, Vratislav Strnad, Ricarda Merten, Philipp Schubert, Michael Lotter, Stephan Kreppner, Rainer Fietkau, Andre Karius","doi":"10.5114/jcb.2024.146671","DOIUrl":"10.5114/jcb.2024.146671","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy and toxicity of interstitial temporary brachytherapy boost for prostate cancer patients using real-world data.</p><p><strong>Material and methods: </strong>Between 2008 and 2016, 115 patients treated with external beam radiotherapy (EBRT) followed by a brachytherapy boost (BT boost) were eligible for this retrospective analysis. Patients received either interstitial high-dose-rate brachytherapy (HDR-BT) with 2 x 9-9.5 Gray (Gy) schedule or pulsed-dose-rate brachytherapy (PDR-BT) with 35 Gy as boost after EBRT (50.4 Gy), up to a total dose of 86-98 Gy (EQD_2α/β = 3). Primary endpoints of the present analysis were cumulative local recurrence rate (LRR), biochemical recurrence-free survival (bRFS), tumor-specific survival, and overall survival (OS). As secondary objective, treatment-related toxicity was evaluated.</p><p><strong>Results: </strong>The median follow-up time was 87 (range, 9-159) months, and the median age was 72 (range, 48-83) years. The median prostate specific antigen value (PSA) was 12.2 (range, 2.4-288) ng/ml. 78/115 (68%) patients had high-risk prostate cancer according to the D'Amico classification. At 7 years, the cumulative LRR for the whole cohort was 1.8%. The 7-year bRFS, cancer-specific survival, and OS were 85.2%, 97.3%, and 88.9%. The 5-year prevalence of late toxicity grade 3 or higher according to the LENT-SOMA scale was 4%. There were no significant differences for treatment outcome or toxicity for HDR vs. PDR treatment. A prostate gland of 50 cm³ or more was not associated with worse treatment efficacy or increased side effects, apart from the prevalence of urethritis after 5 years (<i>p</i> = 0.035).</p><p><strong>Conclusions: </strong>BT boost in patients with prostate cancer is efficient and well-tolerated, with low rates of side effects also in elderly patients. HDR- and PDR-BT were equally efficient and well-tolerated. A large prostate gland is no contraindication for BT. Therefore, BT boost should be offered to all eligible patients.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 6","pages":"391-397"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of adjuvant external beam radiotherapy and brachytherapy in squamous cell carcinoma of oral tongue: Long-term outcomes.","authors":"Shayan Shojaei, Asma Mousavi, Payman Rahimzadeh, Ali Kazemian, Mahdi Aghili, Reza Ghalehtaki","doi":"10.5114/jcb.2024.146837","DOIUrl":"10.5114/jcb.2024.146837","url":null,"abstract":"<p><strong>Purpose: </strong>Squamous cell carcinoma of oral tongue (TSCC) poses a significant health challenge. Radiotherapy is the mainstay of treatment, with external beam radiotherapy (EBRT) and brachytherapy (BT) offering distinct advantages. This study investigated the long-term outcomes associated with each technique.</p><p><strong>Material and methods: </strong>A retrospective analysis was done reviewing medical records of patients diagnosed with TSCC between 2012 and 2022, who underwent surgery and received adjuvant curative-intent radiotherapy. Patients were categorized based on treatment modality: EBRT alone, EBRT combined with brachytherapy (EBRT+ BT boost), or BT alone. Overall survival (OS) and disease-free survival (DFS) were evaluated at 5 years.</p><p><strong>Results: </strong>A total of 84 patients were included, with 57 receiving EBRT, 14 receiving BT alone, and 13 receiving EBRT + BT boost. The median follow-up was 70 months. The 5-year OS rates were 68% for EBRT, 88% for BT alone, and 92% for EBRT + BT boost. The 5-year DFS rates were 62% for EBRT, 88% for BT alone, and 84% for EBRT + BT boost. The 5-year LRC rates were 85% for EBRT, 100% for BT alone, and 92% for EBRT + BT boost. No significant differences between these modalities in terms of median OS, DFS, and LRC were observed.</p><p><strong>Conclusions: </strong>This study explored the long-term outcomes of EBRT and EBRT + BT boost in TSCC patients. While the initial findings suggest potentially improved outcomes with the combined approach, more studies are necessary for validation. Future research should investigate the impact of these techniques on treatment-related toxicities, providing a more comprehensive picture.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 6","pages":"398-409"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Injectable bio-absorbable spacers in brachytherapy for gynecological cancers: A scoping review.","authors":"Carminia Lapuz, Mollie Kain, Michael Chao, Daryl Lim Joon, Claire Dempsey, Jenny Sim","doi":"10.5114/jcb.2024.146834","DOIUrl":"10.5114/jcb.2024.146834","url":null,"abstract":"<p><strong>Purpose: </strong>Insertion of a spacer between tumor and an adjacent organ at risk may improve the therapeutic ratio in gynecological cancer brachytherapy. The purpose of this review was to assess the available literature on the use of injectable bio-absorbable spacers in brachytherapy for gynecological cancers.</p><p><strong>Material and methods: </strong>Embase, PubMed, Medline, and Cochrane Central Register of Controlled Trials were searched until March 28, 2024. Studies reporting on injectable bio-absorbable spacers in gynecological cancer brachytherapy were included. Two independent reviewers completed screening, assessment for eligibility, and data extraction of included studies. Data were collected on spacer material, technique, safety, feasibility, spacer quality, dosimetric values, clinical outcomes, and cost-effectiveness.</p><p><strong>Results: </strong>Seventeen studies met inclusion criteria, with a total of 312 patients and 169 spacers. Clinical application was primarily in cervix cancer brachytherapy (47%) and spacer placement in the recto-vaginal space (88%). Eight different products were used, with no significant spacer-related adverse effects reported. Spacer insertion reduced rectal dose in eight studies, bladder dose in one study, sigmoid dose in four studies, and permitted tumor dose escalation in three studies. Five studies reported on tumor outcomes and eight studies on late toxicities. There were no studies evaluating patient-reported outcomes and cost-effectiveness.</p><p><strong>Conclusions: </strong>Injectable bio-absorbable spacers offer a promising approach for improving the therapeutic ratio in gynecological cancer brachytherapy. There is low certainty evidence available in the literature for their use, and rigorous prospective studies are needed to provide evidence on outcomes.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 6","pages":"467-477"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of using 3D-printed applicators for high-dose-rate brachytherapy in gynecological malignancy.","authors":"Wiwatchai Sittiwong, Pittaya Dankulchai, Utumporn Puangragsa, Tissana Prasartseree, Pongpop Tuntapakul, Chanida Sathitwatthanawirot, Janiya Kittikornchaichan, Sansanee Kongkum, Niyada Piputpanukul, Kantarat Rojanapan","doi":"10.5114/jcb.2024.146670","DOIUrl":"10.5114/jcb.2024.146670","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical outcomes and toxicities of using 3D-printed applicators for image-guided adaptive brachytherapy (IGABT) in gynecological cancer patients.</p><p><strong>Material and methods: </strong>Fourteen patients with gynecological cancers, both primary and recurrent, treated with in-house 3D-printed applicators between 2021 and 2022 were included in the study, and their data were retrospectively reviewed. Timing and patterns of response to treatment were recorded. Kaplan-Meier estimates at 2 years post-treatment were analyzed to obtain local relapse-free survival (LRFS), distant metastasis-free survival (DMFS), progression-free survival (PFS), and overall survival (OS) rates. Actuarial rates of genitourinary (GU), gastrointestinal (GI), and skin and mucosal toxicities were also reported.</p><p><strong>Results: </strong>The median follow-up time for all patients was 27 (IQR: 15.4-32.5) months. Among the primary cases, 2 patients had cervical cancer and 3 had extra-mammary Paget's disease of the vulva. For the recurrent cases, all patients had vaginal relapses. The most common primary cancers were cervical cancer (44.4%) and ovarian cancer (33.3%). At 3 months post-treatment, 13 patients (92.9%) achieved a complete response (CR), and 1 patient (7.1%) showed a partial response (PR). The 2-year rates of LRFS, DMFS, PFS, and OS for primary/recurrent cases were 100%/74.07%, 100%/88.9%, 100%/64.8%, and 100%/88.9%, respectively. The actuarial rates of ≥ grade 2 acute GU and GI toxicities were 7.1% for both groups. For late GU and GI toxicities, the actuarial rates were 14.3% and 21.4%, respectively. In terms of skin and mucosal toxicities, 4 patients (28.6%) developed acute grade 3 toxicity, and 1 patient (7.1%) experienced persistent grade 3 vaginal toxicity.</p><p><strong>Conclusions: </strong>IGABT treatment using 3D-printed applicators for HDR brachytherapy in challenging cases due to incompatibility of the standard applicators with the patient's anatomy or highly advance disease, has demonstrated encouraging outcomes and acceptable toxicity profiles.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 6","pages":"428-436"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of GUI-based simple independent dose calculation software without DICOM data transfer for high-dose-rate brachytherapy.","authors":"Yuha Kim, Yang Sheng, Chunhao Wang, Ke Lu","doi":"10.5114/jcb.2024.146835","DOIUrl":"10.5114/jcb.2024.146835","url":null,"abstract":"<p><strong>Purpose: </strong>Dose calculation in clinical treatment plans must be verified by an independent dose calculation prior to treatment. This study presented an independent second check dose calculation software developed for clinical use.</p><p><strong>Material and methods: </strong>A software developed using Python 3 tool on Google Colab platform enabled its deployment on standard computer systems. The software utilized AAPM TG-43 formalism and AAPM consensus dataset for TG-43 parameters, which were consistent with those of a commercial treatment planning system (TPS; Varian Brachy-Vision). As input, the software only used treatment plan report from TPS. Dosimetric comparisons were performed between software-calculated dose at reference points and corresponding TPS values across 117 clinical treatment plans (102 gynecological cases and 15 intra-operative radiation therapy [IORT] cases using high-dose-rate [HDR] brachytherapy). Gynecological cases were categorized into 12 applicator groups, depending on various combination of tandem, ovoids, and needles, and dose calculation points were manually selected close to prescribed dose.</p><p><strong>Results: </strong>234 dose points (2 points per plan) were calculated. The dose discrepancy between software and TPS was -1% ±0.36% (mean ± standard deviation), with maximum of -3%. The accuracy of the software met AAPM guideline requirement (< 5% deviation). The simplicity of input file in graphical user interface (GUI) environment enabled the software to operate on any computer without additional software, data transfer, or manual data entry. This capability can be particularly advantageous in IORT procedures, which require quick turn-around second check without network connectivity to TPS for DICOM data transfer.</p><p><strong>Conclusions: </strong>A streamlined second check software using TG-43 formalism was developed in Python 3 tool and converted into independent executable GUI, to verify commercial TPS dose calculations in HDR brachytherapy. The software meets current practice guideline and is compatible with commonly used computer systems (Windows, MacOS, and Linux), requiring no additional software, manual data entry, or connection to TPS. The software will also be published online with free public access.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 6","pages":"457-466"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11812136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of MRI-based planning in transperineal interstitial brachytherapy for vaginal-involving tumors.","authors":"Diana Guevara Barrera, Silvia Rodríguez Villalba, Luis Suso-Martí, Enrique Sanchis-Sánchez, Jose Perez-Calatayud, Francisco Blázquez Molina, Maria Jose Pérez-Calatayud, Manuel Santos Ortega","doi":"10.5114/jcb.2024.144683","DOIUrl":"10.5114/jcb.2024.144683","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to analyze patients with vaginal-involving recurrences of gynecological tumors and primary vaginal tumors, treated with transperineal interstitial brachytherapy (P-ISBT). Dosimetric, clinical, and toxicity analysis of these patients was conducted, incorporating MRI in volume definition and dose-volume dosimetry.</p><p><strong>Material and methods: </strong>Forty-two patients were retrospectively analyzed. They were treated with radical or adjuvant intent (in hysterectomized patients with high-risk of relapse). P-ISBT was performed with MUPIT (CT-based planning) in 18 patients (42.9%) and with Template Benidorm (TB) (MRI-based planning) in 24 patients (57.1%).</p><p><strong>Results: </strong>Median age was 59 years (range, 39-78 years). Median clinical target volume (CTV) was 81.4 cc (range, 33.8-286.2 cc) in MUPIT, and 47.5 cc (range, 10-156.4 cc) in TB-treated patients (<i>p</i> = 0.01). Median EQD₂ for EBRT and brachytherapy D₉₀ CTV was 69.2 Gy (range, 27.9-88.8 Gy) in MUPIT, and 77.2 Gy (range, 31-84.3 Gy) in TB. Median rectal D_2cc was 69.2 Gy (range, 23.5-82.6 Gy) in MUPIT, and 66.3 Gy (range, 16.4-75 Gy) in TB. Median bladder D_2cc was 71.5 Gy (range, 23.6-90.8 Gy) in MUPIT, and 66.9 Gy (range, 18.2-78.3 Gy) in TB. Median follow-up was 36.5 months (range, 4-188 months). Local control was 95% at 3 and 5 years. Overall survival was 77% at 3 years, and 66% at 5 years. Disease-specific survival was 81% at 3 years, and 75% at 5 years. Chronic grade 1-2 proctitis presented in 10 patients (24%; 8 treated with MUPIT and 2 treated with TB; <i>p</i> = 0.01). Grade 3 toxicity was documented in 4 patients (9.6%).</p><p><strong>Conclusions: </strong>MRI-based planning is superior to CT-based planning in P-ISBT. It allows for better definition of CTV, resulting in smaller and more selective treatment volumes. Our results show a tendency towards higher D₉₀ CTV dose and lower rectal/bladder D_2cc dose, leading to less events of late rectal toxicity.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 5","pages":"335-343"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-depth feasibility study on conservative surgery, perioperative high-dose-rate brachytherapy, and external beam radiation therapy, with a focus on interstitial brachytherapy for soft tissue sarcomas: Insights from a single-institute experience.","authors":"Purnima Thakur, Vineet Aggarwal, Manish Gupta, Anjali Azad, Naina Negi, Vishal Verma, Parul Sharma, Neeraj Parihar","doi":"10.5114/jcb.2024.144816","DOIUrl":"10.5114/jcb.2024.144816","url":null,"abstract":"<p><strong>Purpose: </strong>Soft tissue sarcomas (STS) due to their aggressive nature, pose challenges in achieving optimal local control (LC) rates following surgery. Brachytherapy offers precise delivery of high radiation doses to target tissues, potentially enhancing LC rates. This feasibility study explored the efficacy of perioperative high-dose-rate brachytherapy (PHDRB) and external beam radiation therapy (EBRT) in improving LC rates for STS, with a particular focus on interstitial brachytherapy and dose escalation strategies for high-risk patient sub-groups.</p><p><strong>Material and methods: </strong>Seven patients with STS underwent conservative surgery and PHDRB between October 2020 and October 2023. PHDRB doses ranged from 3.0 to 3.5 Gy BID in 10 fractions, with or without subsequent EBRT, as indicated. EBRT was delivered in 4-5 weeks after surgical procedure at a dose of 45-50 Gy in 25 treatments, with daily dose of 1.8-2.0 Gy. Brachytherapy techniques and dosimetry guidelines were meticulously implemented to ensure optimal treatment delivery and minimize toxicity.</p><p><strong>Results: </strong>All seven patients tolerated treatment well without acute or late radiation-related complications. Excellent local disease control was achieved in all cases, but three patients developed distant metastases. The overall feasibility and efficacy of PHDRB in combination with EBRT were promising.</p><p><strong>Conclusions: </strong>This study underscores the feasibility and potential efficacy of PHDRB and EBRT for STS treatment. Despite limitations in sample size, the results are promising, warranting further investigation through multi-centric studies. The use of dose-escalated PHDRB in high-risk cases enabled more intensive treatment delivery directly to the tumor bed, which may be critical for enhancing local control in patients with aggressive or large tumors. In facilities with limited resources and a high patient burden, where conformal radiotherapy is unavailable, brachytherapy remains an excellent modality for boosting the tumor bed or serving as a radical radiotherapy treatment.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 5","pages":"362-370"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surface mold brachytherapy for head and neck non-melanoma skin cancer - local control rates and survival: A retrospective analysis.","authors":"Ebrahim Esmati, Romina Abyaneh, Ramin Jaberi, Sahar Naderinasab, Soraya Gholami, Milad Payandeh, Fereshteh Salarvand, Alireza Khalilian, Mahnaz Seiri, Marzieh Lashkari, Mohammad Babaei, Mahdi Aghili, Ali Kazemian, Mitchell Kamrava, Reza Ghalehtaki","doi":"10.5114/jcb.2024.144703","DOIUrl":"10.5114/jcb.2024.144703","url":null,"abstract":"<p><strong>Purpose: </strong>Non-melanoma skin cancer (NMSC) is the most prevalent cancer worldwide, particularly affecting head and neck region. Surgical excision, especially Moh's microsurgery, is the gold standard for treatment. However, certain patients' factors, such as age, comorbidities, and tumor location, require alternative therapies. Radiotherapy, particularly surface mold brachytherapy, offers a viable option for these inoperable or high-risk surgical candidates.</p><p><strong>Material and methods: </strong>This retrospective cohort study included 22 patients with histologically confirmed NMSC, treated with high-dose-rate (HDR) surface mold brachytherapy at the Cancer Institute of Iran between 2019 and 2021. The study focused on primary outcomes, including local control and overall survival, with follow-up assessments for acute and late toxicities, treatment response, and cosmetic outcomes.</p><p><strong>Results: </strong>Twenty-two patients (mean age, 70.94 years) with NMSC were treated. The median lesion size was 2.46 cm. The basal cell carcinoma (BCC) to squamous cell carcinoma (SCC) ratio was 14 : 8. The median maximum depth of clinical target volume was 10 (IQR: 9-15). The median dose was 39 Gy in 13 fractions, with a D₉₀ of 3.04 Gy. Lesions were mainly located on the nose, scalp, and cheek. The 2-year local control rates were 92.9% for BCC and 87.5% for SCC. The 2-year overall survival rate was 71%, with 80% for BCC and 55% for SCC. Eight patients died during the follow-up period, of these, five were due to cancer. Recurrence occurred in one BCC patient (7.1%) and one SCC (12.5%) case. Acute toxicities were mild, and no severe late complications were observed, indicating good tolerance and favorable cosmetic outcomes.</p><p><strong>Conclusions: </strong>Surface mold brachytherapy using cobalt-60 source is an effective and safe treatment for head and neck NMSC, even in thicker than 5 mm lesions, offering high local control rates and favorable cosmetic outcomes. This technique presents a valuable alternative for patients unsuitable for surgery, warranting further research with larger cohorts for confirmation and treatment protocol optimization.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 5","pages":"323-334"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Freiburg flap used as vaginal applicator with/without free-hand interstitial needles in three-dimensional high-dose-rate brachytherapy for vaginal stump recurrence of cervical cancer.","authors":"Mingyuan He, Hongfu Zhao, Yuqing Zhang, Ning Zhang, Zhipeng Zhao, Guanghui Cheng","doi":"10.5114/jcb.2024.144531","DOIUrl":"10.5114/jcb.2024.144531","url":null,"abstract":"<p><strong>Purpose: </strong>To present an innovative deformable applicator that used Freiburg flap as vaginal applicator with or without free-hand interstitial needles in three-dimensional (3D) high-dose-rate (HDR) brachytherapy for vaginal stump recurrence of cervical cancer.</p><p><strong>Material and methods: </strong>Between September 2017 and January 2020, all patients with vaginal stump recurrence after radical hysterectomy of cervical cancer treated with vaginal stump brachytherapy using Freiburg flap as vaginal applicator with or without free-hand interstitial needles were retrospective analyzed. Characteristics related to patients and treatment modality as well as preliminary outcomes and side effects were investigated.</p><p><strong>Results: </strong>Thirteen patients were enrolled, aged between 44 and 77 years, with a median age of 53 years. The number of fractions in Freiburg flap vaginal applicator was 1-5, with a median of 3. At the median follow-up of 54 months (range, 6-72 months), three-year local control and three-year overall survival were 90% and 75%, respectively. Nine patients (69.2%) were evaluated with grade 1 early side effects upon completion of treatment. For late side effects, one patient experienced grade 3 rectal and urinary side effects, with rectum and bladder D_2cc EQD₂ of 69.8 and 76.7 Gy. Another patient developed grade 3 rectal side effect, with rectum D_2cc EQD₂ of 63.2 Gy.</p><p><strong>Conclusions: </strong>Based on the limited cohort, external beam radiotherapy (EBRT) combined with 3D HDR brachytherapy using Freiburg flap vaginal applicator with or without free-hand interstitial needles is an effective treatment option for patients with vaginal stump recurrence of cervical cancer.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 5","pages":"344-351"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective comparison of implant quality between suture-coated seeds and uncoated seeds in prostate cancer brachytherapy.","authors":"Makoto Nakiri, Naoyuki Ogasawara, Hirofumi Kurose, Kosuke Ueda, Hiroki Suekane, Katsuaki Chikui, Kiyoaki Nishihara, Keiichiro Uemura, Kazuhisa Ejima, Ryuji Hoshino, Satoshi Onishi, Keisuke Komiya, Koichiro Muraki, Chikayuki Hattori, Etsuyo Ogo, Tatsuya Ishitake, Tsukasa Igawa","doi":"10.5114/jcb.2024.144175","DOIUrl":"10.5114/jcb.2024.144175","url":null,"abstract":"<p><strong>Purpose: </strong>Displacement minimization of seeds is crucial during surgery in brachytherapy; however, only a few reports have compared the operability of different seeds. TheraStrand-SL is a seed, in which TheraAGX100 is wrapped in polyglactin 910 thread, and intra-prostatic displacement is expected to be reduced compared with that of Thera-AGX100, owing to the complex shape of TheraStrand-SL. We conducted a prospective study on the operability and treatment outcomes of TheraAGX100 and TheraStrand-SL placement by a single operator.</p><p><strong>Material and methods: </strong>The study included 69 patients who received brachytherapy for prostate cancer. Endpoints were comparisons of intra- and post-treatment dose-volume histograms, seed displacement incidence rate, seed displacement distance, seed migration/dropout incidence rate, and adverse events incidence rate between TheraAGX100 (<i>n</i> = 25) and TheraStrand-SL (<i>n</i> = 44) groups.</p><p><strong>Results: </strong>The intra-prostatic displacement incidence rate was significantly lower in the TheraStrand-SL group than in the TheraAGX100 group (TheraAGX100 group: 96.0%; TheraStrand-SL group: 11.4%). Further, the intra-prostatic displacement count per case tended to be lower in the TheraStrand-SL group than in the TheraAGX100 group. Additionally, a comparison of displacement distance per case showed that the TheraStrand-SL group (2.01 mm) had a statistically significantly shorter distance than the TheraAGX100 group (9.22 mm). No significant differences between the two groups were observed in terms of migration, explanted dropout seed count, dose-volume histograms, and adverse events incidence rate.</p><p><strong>Conclusions: </strong>Our study demonstrated the usefulness of TheraStrand-SL against intra-prostatic displacement. We expect TheraStrand-SL to have further applications in brachytherapy, including focal therapy.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 5","pages":"315-322"},"PeriodicalIF":1.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}