Brachytherapy最新文献

{"title":"Accessory secondary plaque in brachytherapy for uveal melanoma","authors":"Weilin Song ,&nbsp;Adrian Au ,&nbsp;Angela Oh ,&nbsp;Alan W. Kong ,&nbsp;James Lamb ,&nbsp;Tara A. McCannel","doi":"10.1016/j.brachy.2025.05.003","DOIUrl":"10.1016/j.brachy.2025.05.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>We describe the technique, indications and outcomes of an accessory secondary brachytherapy plaque for the treatment of uveal melanoma to provide supplemental tumor coverage for the primary brachytherapy plaque.</div></div><div><h3>METHODS</h3><div>Retrospective case series was performed to identify brachytherapy plaque cases for the treatment of primary uveal melanoma where an accessory secondary plaque was created to improve treatment coverage of the uveal melanoma, and positioned at the time of removal of the primary brachytherapy plaque. Baseline tumor, patient characteristics, and clinical outcomes including tumor control, visual acuity, treatment complications, metastases and death treatment were obtained.</div></div><div><h3>RESULTS</h3><div>Of 1,144 uveal melanomas treated with brachytherapy over a 19-year period, eight (0.7%) cases were identified where an accessory secondary brachytherapy plaque was used. Six (75%) patients had uveal melanoma involving the ciliary body. After a mean follow up period of 31.5 ± 5.65 (SE) months, seven (87.5%) patients maintained tumor control and the mean visual acuity was logMAR 0.84 ± 0.57 (Snellen equivalent 20/138). Two (25%) patients developed metastasis, and one (12.5%) patient died of metastatic disease.</div></div><div><h3>CONCLUSION</h3><div>An accessory brachytherapy plaque is a practical solution to manage unexpected deficiencies in plaque coverage of the primary melanoma which avoids treatment delay and minimizes time for potential tumor growth. It may also avoid suboptimal adjunctive treatment options, such as transpupillary thermotherapy, and eliminates radioactive source loss if an entirely new brachytherapy plaque was created. A well-matched accessory secondary plaque may also better conform to the target than a generic plaque with a larger diameter.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 807-813"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gel spacer-assisted salvage brachytherapy for pelvic recurrence after definitive chemoradiotherapy in cervical cancer: A single-institution retrospective study","authors":"Kae Okuma ,&nbsp;Naoya Murakami ,&nbsp;Koji Inaba ,&nbsp;Tairo Kashihara ,&nbsp;Akane Yoshiba ,&nbsp;Ayaka Nagao ,&nbsp;Kana Takahashi ,&nbsp;Madoka Sakuramachi ,&nbsp;Hiroshi Igaki","doi":"10.1016/j.brachy.2025.07.002","DOIUrl":"10.1016/j.brachy.2025.07.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the safety and efficacy of gel spacer-assisted high-dose-rate (HDR) salvage brachytherapy for pelvic recurrence after definitive chemoradiotherapy (CRT) for cervical cancer.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We retrospectively analyzed 15 consecutive patients who underwent salvage HDR interstitial brachytherapy for pelvic recurrence following definitive CRT for cervical cancer between 2016 and 2024. Gel spacers were injected between the recurrent tumors and adjacent organs at risk (OARs), mainly the rectum and bladder, under transrectal ultrasound guidance at each brachytherapy session. The spacer’s effectiveness was evaluated by comparing the hypothetical dose delivered to the gel spacer volume (assuming no spacer was used) with the actual dose to the OARs.</div></div><div><h3>RESULTS</h3><div>The median biological equivalent dose in 2-Gy fractions (EQD2, α/β = 10) delivered during reirradiation was 64.0 Gy (range: 44.5–72.0 Gy). After a median follow-up of 22 months (range: 0–93 months), the complete response rate was 66.7% (10/15). Gel spacer injection significantly reduced the rectal D2cc by a median of 29% (interquartile range [IQR]: 14%–55%) and the bladder D2cc by 16% (IQR: 10%–34%) compared with the hypothetical dose estimates assuming no spacer use (Wilcoxon signed-rank test, <em>p</em> &lt; 0.001). Grade ≥3 late toxicities occurred in only one patient (10.0%) among complete responders, and no spacer-related adverse events were observed.</div></div><div><h3>CONCLUSIONS</h3><div>Gel spacer-assisted salvage brachytherapy significantly reduced radiation exposure to critical OARs, particularly the rectum, while achieving effective tumor control in patients with pelvic recurrence of cervical cancer after definitive CRT. These promising results support this approach as a feasible and safe strategy, warranting further validation in larger prospective studies.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 684-693"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-operative process efficiency for in-room MRI-guided combined intracavitary/interstitial brachytherapy for cervical cancer","authors":"Kitty Chan ,&nbsp;Heather Ballantyne ,&nbsp;Zhihui Amy Liu ,&nbsp;Michael Milosevic ,&nbsp;Jennifer Croke ,&nbsp;Anthony Fyles ,&nbsp;Jelena Lukovic ,&nbsp;Alexandra Rink ,&nbsp;Akbar Beiki-Ardakani ,&nbsp;Jette Borg ,&nbsp;Monica Serban ,&nbsp;Robert A. Weersink ,&nbsp;Jessica L. Conway ,&nbsp;Sarah Rauth ,&nbsp;Julia Skliarenko ,&nbsp;Jason Xie ,&nbsp;Anna Simeonov ,&nbsp;Kathy Han","doi":"10.1016/j.brachy.2025.07.001","DOIUrl":"10.1016/j.brachy.2025.07.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Magnetic resonance image-guided brachytherapy (MRgBT) is the gold-standard treatment for cervical cancer. This study examined workflow times in an integrated MRgBT suite and conventional operating room (OR), and factors contributing to intraoperative efficiency.</div></div><div><h3>METHODS AND MATERIALS</h3><div>Consecutive patients with FIGO stage IB-IVA cervical cancer who underwent MRgBT procedures between 2019-2022 were retrospectively reviewed. Workflow times were collected: applicator insertion, MR-imaging, contouring, treatment planning, treatment execution and total procedure time. Procedure durations between applicators and over time were compared.</div></div><div><h3>RESULTS</h3><div>The 161 patients included in this study underwent 267 procedures in the MRgBT suite, and 56 procedures in the OR using ovoid and tandem applicator (O&amp;T, 46%), ring and tandem (R&amp;T, 28%), or Syed-Neblett template (Template, 27%). The median duration (minutes) of each step was: general anesthesia induction (<span><span>18</span></span>), applicator insertion (31), MR-imaging (28), parallel contouring (48) and applicator/needle registration &amp; treatment plan optimization (83), and treatment execution (19). Total procedure time was much longer in the OR (488 minutes) than MRgBT suite (205 minutes). Template cases were significantly longer in insertion, MR-imaging, contouring, planning and total procedure time (by 52 minutes) compared with those using the R&amp;T/O&amp;T applicators (p&lt;0.001). Total procedure time for Template cases reduced by 10 minutes/year since 2019 (p&lt;0.001). Regardless of applicator type, total procedure time for subsequent insertions was 21 minutes less than the first (p&lt;0.001).</div></div><div><h3>CONCLUSIONS</h3><div>MRgBT procedure time was longer for Syed-Neblett template cases, but shorter in subsequent insertions. The overall procedure time was much shorter in the integrated MRgBT suite than conventional OR.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 729-737"},"PeriodicalIF":1.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wound complications and local recurrence do not differ when using interstitial brachytherapy versus external beam radiation therapy for soft tissue sarcoma","authors":"Martina Hale ,&nbsp;Precious Oyem ,&nbsp;Haley Prough ,&nbsp;Jacob G. Scott ,&nbsp;Zachary D. Burke ,&nbsp;Nathan W. Mesko ,&nbsp;Shauna R. Campbell ,&nbsp;Lukas M. Nystrom","doi":"10.1016/j.brachy.2025.06.003","DOIUrl":"10.1016/j.brachy.2025.06.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Interstitial brachytherapy (BT) is an effective adjuvant treatment alternative to conventional external beam radiation therapy (EBRT) for soft tissue sarcoma (STS). However, little is known about how the wound healing profile of BT compares to that of EBRT.</div></div><div><h3>METHODS</h3><div>This is a comparative retrospective cohort study including patients receiving interstitial BT or conventional EBRT as adjuvant therapy to STS resection between 2015 and 2022. EBRT patients were included if their excised tumors had flat, planar geometries that would have made them good candidates for either EBRT or BT. Patient demographic parameters, wound closure techniques, wound complications, and oncologic outcomes were analyzed. Statistical analysis comparing wound complications and oncologic outcomes were assessed using chi-square tests.</div></div><div><h3>RESULTS</h3><div>Thirty-two patients received BT, and 23 similar patients met inclusion criteria who received EBRT. Baseline characteristics did not differ between groups. Twelve BT (37.5%) and 7 (30.4%) EBRT patients experienced some form of wound healing complication (<em>p</em> = 0.587) with necrosis being the most common complication. Seven (21.9%) BT patients and 6 (26.1%) EBRT patients required at least one reoperation to address complications (<em>p</em> = 0.717). Two BT and 1 EBRT patient developed local recurrence, and nine in each group developed metastasis.</div></div><div><h3>CONCLUSIONS</h3><div>Incidence of wound complications and oncologic outcomes did not statistically differ between BT and EBRT cohorts. In this institutional cohort of appropriately selected STS patients, BT was not inferior to EBRT with respect to wound complication rates and local control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 791-798"},"PeriodicalIF":1.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Canadian brachytherapy experience: Results of the Canadian brachytherapy group national survey","authors":"Kevin Martell ,&nbsp;Mira Keyes ,&nbsp;Ericka Wiebe ,&nbsp;Eric Vigneault ,&nbsp;Amandeep Taggar","doi":"10.1016/j.brachy.2025.06.004","DOIUrl":"10.1016/j.brachy.2025.06.004","url":null,"abstract":"<div><h3>Purpose/Objective</h3><div>Brachytherapy (BT) techniques, skillsets and resource requirements have advanced over the past decade. This study aimed to characterize the current extent of BT availability, expertise and utilization in Canada.</div></div><div><h3>Materials and Methods</h3><div>A 68-question survey covering expertise, training, resources and future challenges to BT programs was created and sent to a single representative at each of the 36 of 49 radiotherapy centers in Canada identified to have an active BT program. Responses were then analyzed in aggregate.</div></div><div><h3>Results</h3><div>Thirty-one responses (response rate 86%) representing all provinces with at least 1 available BT program (9) were obtained. The median number of radiation oncologists practicing BT in each center was 5 (3-6); this represented 33% (24%–43%) of the workforce at each center. Thirty (97%) centers had at least 1 fellowship trained brachytherapist on site. Eleven (35%) respondent centers offered BT fellowship programs and 7 (64%) of those offered the nationally accredited brachytherapy designations at the end of training.</div><div>All 30 respondents (100%) offered BT treatment for endometrial cancer, 26 (87%) for cervical cancer, 25 (83%) for prostate cancer and 20 (67%) for vaginal cancer. In 2024, the median number of endometrial, cervical, prostate and vaginal cancers cases treated were 38 (22–50), 19 (7–33), 66 (41–138) and 1 (0–3), respectively. Sixteen (62%) respondents anticipated an increase in demand for BT resources within the next 5 years.</div></div><div><h3>Conclusion</h3><div>BT programs across Canada are supported by highly trained brachytherapists. BT programs most commonly treat gynecologic and genitourinary malignancies.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 663-669"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HDR and PDR brachytherapy for facial nonmelanoma skin cancer: Outcome and toxicity assessment for 155 patients","authors":"Guillaume Virbel ,&nbsp;Kanta Ka ,&nbsp;Alexandre Escande ,&nbsp;Laurent Mortier ,&nbsp;Mael Barthoulot ,&nbsp;Xavier Liem ,&nbsp;Xavier Mirabel ,&nbsp;Eric F. Lartigau ,&nbsp;Abel Cordoba","doi":"10.1016/j.brachy.2025.06.011","DOIUrl":"10.1016/j.brachy.2025.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Nonmelanoma skin cancer (NMSC), encompassing basal and squamous cell carcinomas, is among the most common malignancies worldwide. While surgery is the standard for early-stage lesions, it can be disfiguring for periorificial facial tumors.</div></div><div><h3>Objective</h3><div>To assess local and regional control, as well as toxicity outcomes, in patients with facial NMSC treated by brachytherapy at a comprehensive cancer center.</div></div><div><h3>Materials and Methods</h3><div>A total of 155 patients were included. Of these, 115 had squamous cell carcinoma and 34 had basal cell carcinoma. The lip was the most frequent site (103 cases), followed by the nose (49 cases). Brachytherapy was exclusive in 128 patients and adjuvant in 27.</div></div><div><h3>Results</h3><div>At 24 months, local and locoregional control rates were 93.9% (95% CI: 89.4–98.5%) and 90.3% (95% CI: 84.8–96.1%) respectively. No grade ≥3 late toxicity was observed.</div></div><div><h3>Conclusion</h3><div>Brachytherapy is a safe and effective organ-preserving option for facial NMSC, particularly in patients with anatomically complex lesions or contraindications to surgery.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 799-806"},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-dose-rate (HDR) brachytherapy boost in combination with external beam radiotherapy for localized prostate cancer: An evidence-based consensus statement","authors":"Sagar A. Patel ,&nbsp;Marisa Kollmeier ,&nbsp;Juanita Crook ,&nbsp;Daniel Krauss ,&nbsp;Gerard Morton ,&nbsp;Albert J. Chang ,&nbsp;Joelle Helou ,&nbsp;I-Chow Hsu ,&nbsp;Cynthia Menard ,&nbsp;Shyamal Patel ,&nbsp;Tyler Robin ,&nbsp;Peter J. Rossi ,&nbsp;Michael J. Zelefsky ,&nbsp;Mitchell R. Kamrava","doi":"10.1016/j.brachy.2025.06.005","DOIUrl":"10.1016/j.brachy.2025.06.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>This guideline presents evidence-based consensus recommendations for high-dose-rate (HDR) brachytherapy boost in combination with external beam radiotherapy (EBRT) for the primary treatment of localized prostate cancer.</div></div><div><h3>METHODS AND MATERIALS</h3><div>The American Brachytherapy Society convened a task force for addressing key questions concerning prostate HDR brachytherapy boost with EBRT for the primary treatment of localized prostate cancer. A comprehensive literature search was conducted to identify prospective and large retrospective studies involving HDR brachytherapy combined with EBRT. Outcomes of interest included biochemical and/or disease control, toxicity, patient-reported quality of life, and the role of androgen deprivation therapy.</div></div><div><h3>RESULTS</h3><div>HDR brachytherapy using Ir-192 in combination with EBRT is an appropriate treatment option for men with intermediate- and high-risk prostate cancer. CT, ultrasound, and/or MRI are imaging platforms that may be utilized for treatment planning and delivery. A single implant/fraction of 15 Gy or 2 implants/fractions of 9.5-11 Gy each are acceptable regimens in combination with EBRT at a dose equivalent of 45-50.4 Gy in 1.8-2.0 Gy fractions. The addition of HDR brachytherapy is expected to improve biochemical control compared with dose escalated EBRT alone. HDR brachytherapy boost is expected to achieve similar biochemical control outcomes as a low dose rate (LDR) brachytherapy boost. Androgen deprivation therapy is recommended for men with unfavorable intermediate and high-risk disease, with varying duration dependent on cancer risk. Use of an HDR brachytherapy technique, as opposed to LDR permanent seeds, has been shown to have less acute genitourinary (GU) and gastrointestinal (GI) toxicity following treatment.</div></div><div><h3>CONCLUSIONS</h3><div>For men with intermediate- and high-risk prostate cancer, HDR brachytherapy boost is a safe and effective technique for dose-escalation that can achieve superior biochemical control compared with EBRT alone, possibly with an improved GU and GI side effect profile compared with an LDR brachytherapy technique.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 644-662"},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144710286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life of patients submitted to radical radiochemotherapy for cervical cancer: Comparison of outcomes between 2D and 3D image guided brachytherapy","authors":"Layse Martins Gama ,&nbsp;Erica Aranha Suzumura ,&nbsp;Geovanne Pedro Mauro ,&nbsp;Patrícia Coelho de Soárez ,&nbsp;Heloisa de Andrade Carvalho","doi":"10.1016/j.brachy.2025.06.006","DOIUrl":"10.1016/j.brachy.2025.06.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To assess QoL in patients with locally advanced cervical cancer treated with radical radiochemotherapy combined with either 2D or 3D brachytherapy, and to compare outcomes between both techniques.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A cross-sectional analytical study was conducted from January 2019 to March 2020. EORTC QLQ-C30 and QLQ-CX24 questionnaires were applied at five time points: before treatment, and 1, 3, 6 and 12 months after treatment. Descriptive statistics, Pearson's chi-square, Fisher’s exact test and Bonferroni test were used (<em>p</em> ≤ 0.05).</div></div><div><h3>RESULTS</h3><div>Seventy six out of 82 patients completed all the assessments. The overall mean global health status significantly improved from 63.7 to 72.0 (<em>p</em> = 0.019), with no significant difference between the 2D and 3D brachytherapy groups (69.8 vs. 67.8; <em>p</em> = 0.672). All functional domains of the QLQ-C30 improved over time, including financial difficulties, regardless of the brachytherapy technique. Sexual activity increased significantly (2.5–32.4, <em>p</em> &lt; 0.0001), but also did sexual worry, menopausal symptoms, reduced sexual enjoyment, and vaginal dysfunction.</div></div><div><h3>CONCLUSIONS</h3><div>Overall improvement in global health and functioning were observed in patients with locally advanced cervical cancer, regardless of the brachytherapy technique used. Despite improved sexual activity, aspects of sexual dysfunction increased, highlighting the need for comprehensive, multidisciplinary care that includes sexual and psychological support, emphasizing the need for individualized care.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 721-728"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review on the International State of Resident Brachytherapy Education","authors":"Joy Ogunmuyiwa ,&nbsp;Emily MacDuffie ,&nbsp;Beth Erickson ,&nbsp;Alina Sturdza ,&nbsp;Mira Keyes ,&nbsp;Mitchell Kamrava","doi":"10.1016/j.brachy.2025.05.005","DOIUrl":"10.1016/j.brachy.2025.05.005","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Brachytherapy is a critical skill in the field of radiation oncology and remains an essential treatment modality in several disease sites. Multiple surveys conducted in the US suggest that a large proportion of residents do not feel comfortable performing several types of brachytherapy procedures upon graduation, highlighting a significant gap in training. To understand if similar issues exist outside the US, a scoping review was conducted to characterize the state of brachytherapy training internationally.</div></div><div><h3>METHODS</h3><div>An electronic search was conducted on PubMed on June 8, 2024 with a restriction on publication year prior to 2015 with the search terms “brachytherapy” and “resident.” Across the eight studies identified, a total of 1187 survey responses reported resident self-assessment of brachytherapy competence.</div></div><div><h3>RESULTS</h3><div>Surveys of residents from multiple continents report high variability in brachytherapy skill confidence with many techniques reporting less than 50% confidence. Surveys that also assessed barriers to brachytherapy training found that low caseload and lack of formal training or assessments were common issues.</div></div><div><h3>CONCLUSIONS</h3><div>These low rates of brachytherapy confidence across the globe are troubling and dedicated interventions, such as the establishment of competency-based assessments and effective simulation-based training, are needed to ensure that future radiation oncologists have the skills to deliver safe, high-quality patient care across the globe.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 814-819"},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual function and dosimetric relationships to neighboring neurovascular substructures among patients treated definitively with Pd-103 LDR prostate brachytherapy","authors":"Keara English ,&nbsp;Michael Roumeliotis ,&nbsp;Tanmay Singh ,&nbsp;Gayane Yenokyan ,&nbsp;Emerson Lee ,&nbsp;Todd McNutt ,&nbsp;Theodore DeWeese ,&nbsp;Daniel Y Song","doi":"10.1016/j.brachy.2025.06.001","DOIUrl":"10.1016/j.brachy.2025.06.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To report sexual health outcomes related to Pd-103 prostate brachytherapy and evaluate dosimetric patterns to the nearby neurovascular structures. To assess potential relationships between dose to neurovascular substructures and erectile function outcomes in an institutional cohort treated definitively with Pd-103 LDR brachytherapy.</div></div><div><h3>MATERIALS AND METHODS</h3><div>The study utilized an IRB-approved database of men receiving low dose rate (LDR) prostate brachytherapy from 2014 to 2019 at our institution for definitive prostate cancer treatment. Patients routinely completed quality of life questionnaires at consultation and at subsequent follow up visits. Outcomes data related to sexual toxicity were evaluated based on the Sexual Health Inventory (SHIM) Questionnaire. Patients with pre-existing erectile dysfunction (SHIM &lt;17 or SHIM confidence score &lt;3) were excluded. The pudendal arteries, neurovascular bundles, subapical region, and penile bulb, were contoured on postimplant imaging and dosimetric data was analyzed. For all statistical comparisons, a student’s t-test was used with alpha of 0.05 indicating significance.</div></div><div><h3>RESULTS</h3><div>About 62 patients met criteria and were included in the analysis. All patients had either very low, low, favorable intermediate or unfavorable intermediate disease at diagnosis. Median follow-up was 5.5 years with total 380 individual questionnaires completed; 58 (93.5%) patients had follow-up greater than 2 years, and 28 (45.2%) patients had follow-up longer than 5 years. Mean baseline SHIM confidence score was 4.0 (SD 0.9). At most recent follow up, 34 patients (53%) had a SHIM confidence score greater than or equal to 3. Mean confidence SHIM for the cohort decreased from 4 to 3 after treatment and did not return to baseline over time. At the 6-month, 2-year, 4-year, and 5-year time points, the high dose NVB cohort demonstrated worse SHIM scores. At 5-year follow up, mean SHIM confidence was 2.2 ± 1.3 for the high dose group versus 3.6 ± 1.3 in the low dose group.</div></div><div><h3>CONCLUSIONS</h3><div>Erectile function appears to decrease following prostate brachytherapy with LDR Pd-103 seeds, demonstrated by a reduction in post procedural SHIM scores from baseline without recovery to preprocedure scores. The dose to adjacent neurovascular substructures other than NVBs is exceedingly low following Pd-103 LDR prostate brachytherapy and is unlikely to be the primary contributor to decreased sexual function related to this treatment modality. Out of the individual substructures, NVB dose may be the most critical.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 5","pages":"Pages 783-790"},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}