Brachytherapy最新文献

{"title":"Multicatheter interstitial brachytherapy-delivered APBI as single-fraction treatment in older breast cancer patients: A feasibility retrospective institutional analysis","authors":"Catarina van der Elzen ,&nbsp;Diana Correia ,&nbsp;Sofia Garcia ,&nbsp;Pedro Fernandes ,&nbsp;Alexandre Pereira ,&nbsp;Sara Pinto ,&nbsp;Marina Maçães ,&nbsp;Inês Lima ,&nbsp;Lurdes Trigo","doi":"10.1016/j.brachy.2025.11.002","DOIUrl":"10.1016/j.brachy.2025.11.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Accelerated partial breast irradiation (APBI) has emerged as an alternative to whole-breast irradiation (WBI) for selected patients with low-risk early breast cancer (EBC). While external beam APBI techniques are widely available, multicatheter interstitial brachytherapy (MIB) offers superior conformity and reduced normal tissue exposure. We evaluated the feasibility, toxicity, and early outcomes of an ultra-hypo fractionated approach using a single-fraction MIB-APBI in older patients.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We conducted a single-institution retrospective study of 20 women (range, 69–88 years) with low-risk EBC treated with a single-fraction APBI (uAPBI) 16 Gy using MIB, between January 2023 and October 2024. All patients had undergone lumpectomy with sentinel lymph node biopsy. Eligibility criteria included age ≥65 years, tumor size ≤3 cm, unifocal disease, sentinel node-negative status and microscopically clear resection margins. Acute and late toxicities, cosmetic outcomes, oncological endpoints and dosimetric parameters were evaluated.</div></div><div><h3>RESULTS</h3><div>Acute toxicity was limited to Grade 1/2 dermatitis in 25% of patients while no severe late toxicity was observed. Cosmetic outcomes were excellent to good in 100% of patients. At median follow-up of 18 months (range, 10-26), all patients remained alive with no locoregional recurrence or distant metastasis. Dosimetric parameters demonstrated excellent target coverage (median V100%: 97%, range 90–98%).</div></div><div><h3>CONCLUSIONS</h3><div>Single-fraction MIB-based APBI delivering 16 Gy appears to be a feasible, well-tolerated, and effective treatment approach for carefully selected older patients with EBC. This ultra-hypo fractionated approach significantly reduces treatment burden while maintaining excellent local control and favorable toxicity profiles.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 373-380"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746116","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":"Caudally directed posterior high-dose-rate brachytherapy for reirradiation of para-aortic lymph node recurrence: A technical innovation enabled by interventional radiology","authors":"Kae Okuma ,&nbsp;Yasuaki Arai ,&nbsp;Mizuki Ozawa ,&nbsp;Hiroki Nakayama ,&nbsp;Hiroyuki Okamoto ,&nbsp;Ayaka Nagao ,&nbsp;Koji Inaba ,&nbsp;Tairo Kashihara ,&nbsp;Kana Takahashi ,&nbsp;Madoka Sakuramachi ,&nbsp;Akane Yoshiba ,&nbsp;Hiroshi Igaki","doi":"10.1016/j.brachy.2025.11.008","DOIUrl":"10.1016/j.brachy.2025.11.008","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Reirradiation for para-aortic lymph node (PALN) recurrence is technically challenging due to prior radiation exposure and the anatomical proximity of critical organs such as the small intestine and kidneys, making external beam radiation therapy (EBRT) difficult or unfeasible. High-dose-rate interstitial brachytherapy (HDR-IBT) offers a highly localized treatment alternative; however, it requires precise applicator placement to ensure safety and efficacy.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We report a case of PALN recurrence located between the aorta and inferior vena cava (IVC) in a patient previously treated with multiple courses of EBRT. Due to the lesion’s high-risk location and prior irradiation, further EBRT was not a viable option. In collaboration with interventional radiologists, a novel posterior paravertebral approach was adopted. Under fluoroscopic and computed tomography (CT) guidance, a 17 G percutaneous transhepatic cholangiography (PTC) needle was inserted from the patient's back. The guidewire was advanced through the psoas muscle and intentionally redirected caudally at an angle of nearly 90 degrees to avoid major vascular structures. Following tract dilation using a ureteral balloon and dilator system, a flexible brachytherapy applicator was inserted and fixed in place. The patient received six fractions of 5 Gy (total dose: 30 Gy), with the applicator maintained <em>in situ</em> throughout the treatment period.</div></div><div><h3>RESULTS</h3><div>The treatment was completed without any adverse events. CT imaging at 4 months post-treatment showed tumor shrinkage and reduced contrast enhancement. No radiation-related toxicities were observed during or after treatment. Local control has been maintained for over 4 years.</div></div><div><h3>CONCLUSIONS</h3><div>This case demonstrates the feasibility and safety of fractionated HDR-IBT for reirradiation of deeply located PALN recurrence in a previously irradiated field. While single-fraction HDR-IBT can be performed via a direct posterior approach, fractionated treatment requires stable applicator placement over several days. To mitigate the risk of vascular injury due to applicator displacement, precise angulation of the insertion trajectory was critical. This report highlights how interdisciplinary collaboration enabled accurate, vessel-sparing needle placement, providing a minimally invasive and effective treatment option for patients with PALN recurrence who are not candidates for further EBRT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 381-385"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776807","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":"Ultrasound and CT-guided 125I implantation combined with TACE therapy in the treatment of recurrent HCC after RFA","authors":"Ningjie Li ,&nbsp;Ping Yang ,&nbsp;Jun Fang ,&nbsp;Hongbo Li ,&nbsp;Yulei Wan ,&nbsp;Xizi Wu ,&nbsp;Li Wang","doi":"10.1016/j.brachy.2025.11.001","DOIUrl":"10.1016/j.brachy.2025.11.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>This study aimed to evaluate the efficacy and safety of combining transarterial chemoembolization (TACE) with 125Iodine (125I) seed implantation for the treatment of recurrent hepatocellular carcinoma (HCC) following radiofrequency ablation (RFA).</div></div><div><h3>METHOD</h3><div>A retrospective analysis was conducted on 221 HCC patients treated between January 2016 and January 2025, divided into two groups: TACE monotherapy (<em>n</em> = 132) and TACE combined with 125I seed implantation (TACE-125I, <em>n</em> = 89). Treatment outcomes, including overall survival (OS), progression-free survival (PFS), and recurrence patterns, were assessed. Complications were evaluated using the Common Terminology Criteria for Adverse Events (CTCAE v5.0).</div></div><div><h3>RESULTS</h3><div>The TACE-125I group demonstrated significantly improved survival outcomes compared to the TACE group, with a median OS of 38 months (95% CI: 34.6–41.4) versus 21 months (95% CI: 14.6–27.4) (<em>p</em> &lt; 0.001) and a median PFS of 19 months (95% CI: 13.7–24.3) versus 10 months (95% CI: 7.8–12.2) (<em>p</em> &lt; 0.001). Local recurrence rates were lower in the TACE-125I group (10 cases vs. 20 cases). The safety profile was favorable, with no severe complications or procedure-related fatalities. Multivariate analysis identified the neutrophil-to-lymphocyte ratio (NLR) as an independent prognostic factor for both OS and PFS.</div></div><div><h3>CONCLUSIONS</h3><div>The combination of TACE and 125I seed implantation significantly improves survival and local tumor control in recurrent HCC after RFA, offering a promising therapeutic option for patients with limited treatment alternatives. Further prospective studies are needed to validate these findings and optimize patient selection criteria.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 325-332"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919302","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":"Prospective study on tumor control, survival, toxicity and quality of life after EBRT and an HDR-brachytherapy boost in intermediate to high-risk prostate cancer patients","authors":"Max Peters ,&nbsp;Tonnis T. Nuver ,&nbsp;Marnix J.A. Rasing ,&nbsp;Margo C. Noordhoek ,&nbsp;Marie A.D. Haverkort ,&nbsp;Erik C. Schimmel ,&nbsp;Wout J. Schoevers ,&nbsp;Michal D. Czerwinski ,&nbsp;Peter S.N. van Rossum ,&nbsp;Robert A.J. Kattevilder ,&nbsp;André W. Minken","doi":"10.1016/j.brachy.2025.12.003","DOIUrl":"10.1016/j.brachy.2025.12.003","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>Brachytherapy boost improves biochemical disease-free survival (bDFS) for intermediate/high-risk prostate cancer, but may increase toxicity. We prospectively assessed tumor control, survival, toxicity, and quality of life (QoL) in a large cohort treated with high-dose-rate (HDR) brachytherapy boost after hypo-fractionated external beam radiotherapy (EBRT) and assessed predictors for tumor control and survival.</div></div><div><h3>METHODS AND MATERIALS</h3><div>From 2010 to 2020 patients received EBRT (58 Gy in 20 fractions to prostate/seminal vesicles or 62.5 Gy in 25 fractions with 50 Gy to pelvic nodes), followed by a 10 Gy HDR brachytherapy boost, and androgen deprivation therapy (ADT) up to 3 years. Biochemical recurrence was defined by the Phoenix criterion. Toxicity (CTCAE v3.0) and QoL (IPSS, Likert scales for bowel and erectile function) were prospectively recorded. Outcomes were analyzed using Kaplan-Meier analysis and Cox/competing-risk models.</div></div><div><h3>RESULTS</h3><div>Among 274 patients (267 high risk), median follow-up was 95 months. Eight-year bDFS and overall survival (OS) were both 76%, and prostate cancer-specific survival (PCASS) 95%. PSA nadir &gt; 0.1 ng/mL was the strongest predictor for biochemical failure and PCASS (8-year bDFS: 88% vs. 31%, <em>p</em> &lt; 0.001). Longer time to PSA nadir improved tumor control and survival. Late Grade 3 genitourinary toxicity occurred in 4.4% and gastrointestinal in 0.7%. Median IPSS increased from 7 to maximum 10 (<em>p</em> &lt; 0.001), minor bowel symptoms from 3% to maximum 13%. Complete erectile dysfunction rose from 18% to maximum 47% (<em>p</em> &lt; 0.001).</div></div><div><h3>CONCLUSION</h3><div>EBRT with ADT and HDR brachytherapy boost provides durable tumor control with acceptable long-term toxicity. PSA nadir and time to nadir are strong predictors for outcomes and may support personalized follow-up strategies.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 313-324"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919240","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 global need for brachytherapy innovation in cervical cancer","authors":"Sara Perelmuter ,&nbsp;Onyinye Balogun","doi":"10.1016/j.brachy.2025.11.004","DOIUrl":"10.1016/j.brachy.2025.11.004","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 255-261"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835416","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":"Is single implant and multiple fractions radio-biologically iso-effective for cervical cancer high-dose-rate brachytherapy: Observation from patient cohorts during COVID pandemic","authors":"Supriya Chopra ,&nbsp;Asesh Samanta ,&nbsp;Arunima Nagar ,&nbsp;Prachi Mittal ,&nbsp;Ankita Gupta ,&nbsp;Jaahid Mulani ,&nbsp;Jeevanshu Jain ,&nbsp;Yogesh Ghadi ,&nbsp;Prachi Sawant ,&nbsp;Sushmita Rath ,&nbsp;Jaya Ghosh ,&nbsp;Sudeep Gupta","doi":"10.1016/j.brachy.2025.11.010","DOIUrl":"10.1016/j.brachy.2025.11.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To report clinical outcomes of cervical cancer patients treated with single implant and multiple fractions of high-dose-rate brachytherapy (HDR BT).</div></div><div><h3>MATERIALS AND METHODS</h3><div>Patients treated with (chemo)radiation followed by single implant with all fractionated HDR BT delivered within 24–36 hours were included. Treatment protocol recommended &gt;70 Gy equivalent doses in 2 Gy (EQD2_10Gy) at point A for intracavitary BT (ICBT) and &gt;85 Gy EQD2_10Gy for those receiving interstitial-intracavitary BT (IC-ISBT). Local control, locoregional control and disease-free survival was estimated along with late gastrointestinal (GI) and genitourinary (GU) toxicity.</div></div><div><h3>RESULTS</h3><div>From 2020–2022, 116 patients were treated with single implant multiple fractions HDR-BT. The median dose to Point A, HRCTV D90, B2cc, R2cc and S2cc was 75.1 (72.4–77.8), 80.2 (76–84), 85.2 (83.1–90.1), 69.1 (65.0–73.9) and 67.9 (61–75.3) Gy for those treated with ICBT. The median dose to high risk clinical target volume D90, Bladder 2cc, Rectum 2cc and Sigmoid 2cc was 83.2 (78.2–88.4), 87.4 (84.2–91), 69.6 (64.1–75) and 68.1 (59.5–77.1) Gy in those with IC-ISBT respectively. The median follow-up was 36 months (2–60 months). The 5-year local control, loco-regional control, disease free survival and overall survival was 89%, 84%, 70.8% and 81.6% respectively. Grade ≥3 GI and GU toxicity were 11.3% and 1.7% respectively. The incidence Grade ≥3 GI was higher in those who received 8–9 Gy in three fractions than 5–7.5 Gy in 3–4 fractions.</div></div><div><h3>CONCLUSION</h3><div>The abbreviated HDR BT schedule of single implant 3–4 fractions for LACC patients is radiobiological iso-effective for tumor control. There seems to be a fraction size dependence of abbreviated fractionation schedule for severe GI toxicity.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 291-299"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145822386","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":"Randomized trial of dose de-escalation in low-risk prostate cancer patients implanted with Pd-103","authors":"Martin King ,&nbsp;Grgur Mirić ,&nbsp;Mutlay Sayan ,&nbsp;Robert Galbreath ,&nbsp;Ryan Fiano ,&nbsp;Kent Wallner ,&nbsp;Peter Orio","doi":"10.1016/j.brachy.2025.12.002","DOIUrl":"10.1016/j.brachy.2025.12.002","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Palladium-103 (Pd-103) brachytherapy has been associated with excellent oncologic outcomes for favorable risk prostate cancer. Our purpose was to evaluate whether de-escalated dose Pd-103 was associated with a difference in biochemical failure (BF) compared with standard-dose Pd-103 for low-risk prostate cancer.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Patients with low-risk prostate cancer (cT1b-T2b, Gleason 6, and prostate-specific antigen (PSA) ≤ 10 ng/mL) were randomized 1:1 to standard dose (125 Gy) versus de-escalated dose (110 Gy) Pd-103 brachytherapy. The primary endpoint was biochemical failure (BF), defined as PSA ≥ 0.4 ng/mL. Fine-Gray regression analysis was used to identify baseline factors associated with BF, with death as a competing risk. Grade 3 genitourinary (GU) and gastrointestinal (GI) toxicities were reported.</div></div><div><h3>RESULTS</h3><div>This analysis included 316 patients, who were randomized between February 2006 and February 2014. At a median follow-up of 11.0 years, the 12-year cumulative incidences of BF for the standard and de-escalated dose arms were 1.3% and 2.7%, respectively (<em>p</em> = 0.40). On multivariate regression, body mass index (adjusted sub-distribution hazard ratio (sHR): 1.18; 95% confidence interval (CI) = 1.06–1.32; <em>p</em> = 0.003) and PSA (adjusted sHR: 1.76; 95% CI = 1.36–2.28; <em>p</em> &lt; 0.001) were associated with BF. Cumulative incidences of Grade 3 GU toxicities at 12-years were 6.5% and 3.9% for standard and de-escalated arms, respectively (<em>p</em> = 0.34). There were no Grade 3 GI toxicities in either arm.</div></div><div><h3>CONCLUSIONS</h3><div>De-escalated dose Pd-103 (110 Gy) could be considered for patients with low-risk prostate cancer who opt for definitive treatment.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 306-312"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145914076","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":"Towards robust deep learning-based autosegmentation in MRI-planned gynecological brachytherapy: Importance of scalable development and comprehensive evaluation","authors":"Patricia Jule Oliva ,&nbsp;Shrimanti Ghosh ,&nbsp;Fleur Huang ,&nbsp;Ericka Wiebe ,&nbsp;Julie Cuartero ,&nbsp;Sunita Ghosh ,&nbsp;Pierre Boulanger ,&nbsp;Jihyun Yun ,&nbsp;Kumaradevan Punithakumar ,&nbsp;Geetha Menon","doi":"10.1016/j.brachy.2025.12.007","DOIUrl":"10.1016/j.brachy.2025.12.007","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To present comprehensive development and evaluation methodologies for a generalizable deep learning (DL)-driven autocontouring model of standard pelvic organs-at-risk (OARs) in MRI-planned cervical brachytherapy.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A curated dataset of 200 3D-MRIs (85% training/validation, 15% testing) including multiple applicator types, varying treated anatomies, and manual contours of OARs (bladder, rectum, sigmoid, small bowel) by 3 physicians was utilized to develop an nnU-Net-based autocontouring model. Iterative tuning was conducted to determine the optimal hyperparameters and enhance evaluation metrics. Model performance was assessed using quantitative metrics, like geometric (e.g., Dice Coefficient (DC) and Hausdorff Distance 95th Percentile (HD95)) and dosimetric (dose-volume histograms (DVHs), dose differences (ΔD2cc)), and then correlated with qualitative physician-review (modified Turing and Likert tests).</div></div><div><h3>RESULTS</h3><div>Geometric metrics were best for bladder (e.g., mean ± SD DC|HD95(mm) 0.93 ± 0.02|2.26 ± 1.07) with greater variability exhibited for small bowel (0.62 ± 0.16|24.90 ± 14.36). Dosimetric comparisons of manual vs predicted contours showed high agreement in DVHs, with mean ΔD2cc &lt;0.60 Gy EQD2₃ across all OARs. Model performance was consistent, irrespective of applicator type, OAR volume, or contourer. Quantitative scores in support of DLM were not always associated with as favorable qualitative results, yet physician-review showed clinical acceptability (80% for bladder and rectum).</div></div><div><h3>CONCLUSION</h3><div>The DL-based autocontouring model, trained on a heterogeneous in-house dataset, demonstrates clinical acceptability for OARs as determined by comprehensive evaluation. It also shows promise for translatability to target contouring, and adaptability to other gynecological (noncervix) brachytherapy applications. Differences in qualitative and quantitative results exist; directionality and magnitude should be considered in clinical usability assessments of brachytherapy autocontouring models.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 361-372"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146032068","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":"Low dose iodine-125 brachytherapy and transpupillary thermal therapy for small- to medium-sized choroidal melanoma","authors":"S Fattahi ,&nbsp;CL Deufel ,&nbsp;KV Astafurov ,&nbsp;TW Olsen ,&nbsp;SL Stafford ,&nbsp;MA Neben Wittich ,&nbsp;WS Harmsen ,&nbsp;JK Viehman ,&nbsp;LA Dalvin ,&nbsp;IA Petersen ,&nbsp;KS Corbin","doi":"10.1016/j.brachy.2025.11.011","DOIUrl":"10.1016/j.brachy.2025.11.011","url":null,"abstract":"<div><h3>PURPOSE</h3><div>COMS established iodine-125 (¹²⁵I) brachytherapy as standard of care for medium-sized choroidal melanomas. However, there remains a gap in the literature regarding reduced dosing for medium-sized choroidal melanomas and standard dosing for small-sized choroidal melanomas. We explored the impact of reduced dose ¹²⁵I brachytherapy on local tumor control and ocular adverse events (AEs).</div></div><div><h3>METHODS</h3><div>Patients diagnosed 2005–2019 with choroidal melanoma &lt;5 mm thick and managed with ¹²⁵I brachytherapy dose of 65 Gy to depth of 5 mm were included. Dose metrics were calculated using Monte Carlo-based dosimetry. Kaplan-Meier method was used to estimate overall survival and radiation-related AEs. Distant metastasis and local recurrence were reported using cumulative incidence with death as a competing risk. Univariate and multivariate associations were analyzed using Cox proportional hazards regression.</div></div><div><h3>RESULTS</h3><div>143 patients met inclusion criteria with median follow-up of 7 years. Five-year Kaplan-Meier estimates of ocular AEs were 59.6% radiation maculopathy, 42.0% cystoid macular edema, 55.2% nonproliferative radiation retinopathy, 10.8% proliferative radiation retinopathy, and 35.6% radiation papillopathy. Five-year cumulative incidence of local recurrence was 0%, 5-year cumulative incidence of distant metastasis was 6.1%, and 5-year Kaplan-Meier estimate of overall survival was 96.5%.</div></div><div><h3>CONCLUSION</h3><div>Reduced dose ¹²⁵I brachytherapy is feasible with excellent local tumor control.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 386-395"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776834","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":"Evaluation of AI chatbot responses to brachytherapy frequently asked questions","authors":"Ramez Kouzy ,&nbsp;Ibrahim Ibrahim ,&nbsp;Paul Nemr ,&nbsp;Saketh Vinjamuri ,&nbsp;Bassam Ballout ,&nbsp;Juan Sebastian Gonzalez Gonzalez Diaz ,&nbsp;Dalissa Negron Figueroa ,&nbsp;Molly B. El Alam ,&nbsp;Zakaria El Kouzi ,&nbsp;Comron Hassanzadeh ,&nbsp;Osama Mohamad ,&nbsp;Chris Weil ,&nbsp;Lauren Colbert ,&nbsp;Ann Klopp","doi":"10.1016/j.brachy.2025.10.005","DOIUrl":"10.1016/j.brachy.2025.10.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients are increasingly using artificial intelligence (AI) chatbots for health information. Evaluating their reliability for specialized topics, such as brachytherapy, is crucial for guiding their safe use. We assessed a readily accessible AI chatbot's suitability for answering frequently asked questions (FAQ) related to brachytherapy.</div></div><div><h3>Methods</h3><div>We compared responses from an AI chatbot (ChatGPT 4o-mini) against gold standard (GS) authoritative sources for 10 brachytherapy frequently asked questions. Four blinded board-certified brachytherapy experts evaluated 80 response pairs using metrics, including accuracy, clinical appropriateness, readability, and tone. Five simulated patient personas with varying literacy levels were used to assess helpfulness, readability, and emotional tone. The objective readability metrics were also calculated.</div></div><div><h3>Results</h3><div>Experts rated the AI chatbot higher for accuracy (75% highly/mostly accurate vs. 50% for GS) and appropriateness (77% vs 55%), although inaccuracies were noted in both sources in a blinded review. Simulated patients preferred GS responses (62% vs. 34%), particularly lower-literacy personas, citing better perceived readability (92% easy/very easy vs. 44% for AI) and a more reassuring tone (42% vs. 24% for AI). Objective analysis confirmed that both sources significantly exceeded the recommended reading levels (e.g., &gt;12th grade Flesch-Kincaid), with AI responses being substantially longer. Performance varied considerably across individual questions for both AI and GS sources.</div></div><div><h3>Conclusions</h3><div>In this blinded cross-sectional evaluation, a publicly available AI chatbot provided accurate responses to brachytherapy-related FAQs. However, further development and validation focused on accessibility, trustworthiness, and user-centered design are required before these tools can be safely and effectively integrated into patient-care workflows.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"25 2","pages":"Pages 275-282"},"PeriodicalIF":1.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776770","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}