Brachytherapy最新文献

{"title":"BP06 Presentation Time: 4:45 PM","authors":"Usha Abraham MS, DABR, Ranjini Tolakanahalli Ph.D., Fiona Perk RTT, Marc Morcos Ph.D., Maria A. Rodrigues MD, Alonso Gutierrez Ph.D., Vibha Chaswal Ph.D.","doi":"10.1016/j.brachy.2024.08.030","DOIUrl":"10.1016/j.brachy.2024.08.030","url":null,"abstract":"<div><h3>Purpose</h3><div>To present dosimetric outcomes of Strut Adjusted Volumetric Implant (SAVI) brachytherapy treatment plans delivered over 4 years using Tri-fraction Radiation Therapy Used to Minimize Patient Hospital Trips (TRIUMPH-T) Trial at our institution; and investigation into a plan-coverage-complexity indicator.</div></div><div><h3>Method and Materials</h3><div>Retrospective analysis on dosimetric parameters derived from clinically delivered treatment plans using different size SAVI (Cianna Medicals, Aliso Viejo CA) applicators during 2019 and 2023 were performed. Treatment plans were prepared using Ir-192 source modeled in BrachyVision (Varian Medical Systems, Inc.) and Oncentra (Elekta Brachy, Veenendaal, The Netherlands) treatment planning systems. Triumph-T trial dose regimen (22.5 Gy in 3 fractions, Bi-daily, 6 hours apart) and dosimetric criterion were employed for APBI delivery. Target [PTV_Eval] and organs at risk (OAR) [chestwall and ribs] were delineated in accordance with NSABP-B39/RTOG-0413 and Triumph-T trials. A 3 mm skin rind was contoured, as institutional preference, for skin-sparing. V<sub>90%</sub> ≥ 90% was desired for PTV_Eval with V<sub>150%</sub> < 40cc and V<sub>200%</sub> < 17 cc for high dose metrics and D<sub>0.03cc</sub> < 100% and D<sub>0.03cc</sub> < 110% for skin and chestwall/ribs, respectively. A PTV-ratio was defined in this study as the ratio of PTV_Eval to PTV<sub>1cm</sub> (volume encompassing 1 cm expansion around lumpectomy cavity) and was analyzed for linear correlation with the PTV_Eval coverage (V<sub>90%</sub>) metric to determine feasibility of serving as a plan-coverage-complexity indicator. Pearson correlation coefficient (with a two-tailed t-test of significance; p<0.05) was used.</div></div><div><h3>Results</h3><div>Our center treated 147 patients with median PTV_Eval volume of 67.1 cc [35.9 cc-116.1 cc] using SAVI brachytherapy, following the Triumph-T trial planning technique. Amongst these, twenty (n=20) cavities were treated with 6-1-mini SAVI, fifty-two (n=52) cavities with 6-1 SAVI, fifty (n=50) with 8-1 SAVI, and twenty-five (n=25) with 10-1 SAVI, and these cavity groups had a median volume of 9.7 cc [7.7 cc - 15.4 cc], 18.1 cc [14.9 cc - 22.8 cc], 33.3 cc [15.3 cc - 41.3 cc] and 53.1cc [21.9 cc - 65.4 cc], respectively. Excellent coverage was achieved for PTV_Eval with mean V<sub>90%</sub> at 97.0% ± 2.3%. Mean V<sub>150%</sub> and V<sub>200%</sub> were at 28.2cc ± 3.5cc and 12.7cc ± 2.4cc, respectively. From 6-1-mini to 10-1 SAVI, V<sub>150%</sub> and V<sub>200%</sub> values increase from 20.4cc to 35.7cc and 10.8cc to 14.1cc, respectively. For OARs, the mean D<sub>0.03cc</sub> to skin, chestwall, and ribs were 86.9% ± 15.5%, 88.7% ± 30.6% and 59.5% ± 23.4%, respectively, and were within tolerance. Average PTV-ratio values were 0.92 ± 0.08 for all plans evaluated. Starting from 6-1mini to the 10-1 SAVI, the Pearson correlation coefficients between PTV-ratio an","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527274","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":"GPP06 Presentation Time: 11:15 AM","authors":"Keara English MD, Michael Roumeliotis Ph.D., Tim Lin MD, Todd McNutt PhD, Mohammad Rezaee PhD, Junghoon Lee PhD, Akila Viswanathan MD, MPH","doi":"10.1016/j.brachy.2024.08.092","DOIUrl":"10.1016/j.brachy.2024.08.092","url":null,"abstract":"<div><h3>Purpose</h3><div>We report on recurrence patterns and prognostic features among pts treated definitively for primary vaginal cancer with placement of interstitial catheters in a magnetic resonance (MR) simulator and treatment in an adjacent brachytherapy suite.</div></div><div><h3>Methods</h3><div>The cohort included 53 pts receiving radiotherapy (RT) for primary vaginal cancer from 9/2016-1/2022 at a single institution. Pts received external beam radiation (EBRT) plus high-dose rate brachytherapy (HDR-BT) (w/ MR guidance, Espree, Siemens, Inc.), or HDR-BT alone in the following settings: prior history of anal cancer s/p RT, early stage I, multiple co-morbidities w/ severe colitis or limited life expectancy. HDR-BT was delivered via Syed interstitial template or multichannel cylinder. Pre-procedure, pts had MR (T1-, T2-, diffusion-weighted, and dynamic contrast enhance) imaging to determine applicator required for ideal coverage. Interstitial HDR-BT pts had catheters placed in the MR room. Sequences performed post applicator insertion included T2-Space and high-res T2. Contouring of gross tumor volume (GTV), clinical target volume (CTV) of vagina, additional gynecologic organs if present (uterus, cervix), and normal tissues was performed based on an internal protocol. Interstitial cases had a subsequent CT scan to validate catheter digitization. Patient characteristics, treatment toxicity, and prognostic markers were analyzed. Kaplan-Meier (KM) estimates were generated for disease-free survival (DFS), local control (LC), and overall survival (OS).</div></div><div><h3>Results</h3><div>41 pts were included. Median age was 61 yrs (range 33 - 90); median follow up was 28 months. Stage: FIGO I - 9 (22%), FIGO II - 11 (26.8%), FIGO III - 9 (22%), FIGO IV - 7 (17%), and recurrent - 5 (12.2%). 30 pts (73%) were squamous cell carcinoma, 5 pts (12.2%) were adenocarcinoma. RT with both EBRT+HDR-BT was done in 35 (85.4%) cases. 6 (14.6%) pts received HDR-BT alone. Syed interstitial implant was used for 40 (97.5%); 1 received multichannel cylinder. 33 (80%) received concurrent systemic therapy, primarily with cisplatin (24 pts). Median MR-defined CTV volume was 19.9 cm<sup>3</sup> (range 0.77 cm<sup>3</sup> - 202.1 cm<sup>3</sup>). Among the pts with a measurable lesion on MRI, median pre-RT tumor size was 4.5 cm (range 1.2-16.6cm). Median size at 3-month MR was 2.8 cm (range 1.3-13.3cm). Among pts who received EBRT+HDR-BT, median total D90 EQD2 was 70.2 Gy (range 56.6-91.5Gy). Median bladder, rectum, sigmoid, and bowel total EQD2 were 62.7 Gy (range 47.9-88Gy), 59.8 Gy (range 50.7-83.5Gy), 50.3 Gy (range 39.7-78.4Gy), and 50.1 Gy (range 43.2-89.9Gy), respectfully. For the pts who received HDR-BT only, median D90 EQD2 was 39.1 Gy (range 14.3-74.5Gy). Median bladder, rectum, sigmoid, and bowel EQD2 were 24.4 Gy (range 6.7-50.5Gy), 33.6 Gy (range 2.2-37.6Gy), 9 Gy (range 1.7-20.6Gy), and 2.4 Gy (range 2.3-28.3Gy). 12 pts progressed, none with local-onl","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527283","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":"Saturday, July 13, 202410:30 AM - 11:30 AM GPP01 Presentation Time: 10:30 AM","authors":"Kara D. Romano MD ,&nbsp;Gabriella Macchia MD ,&nbsp;Melissa Christiaens MD ,&nbsp;Susan Lalondrelle MD ,&nbsp;Xiang Zhang MD ,&nbsp;Andréia Cristina De Melo MD, PhD ,&nbsp;Klaudia Reginacova MD, PhD ,&nbsp;Limor Helpman MD ,&nbsp;Ali Ayhan MD ,&nbsp;Flora Zagouri MD, PhD ,&nbsp;Linn Woelber MD ,&nbsp;Kristina Hellman MD, PhD ,&nbsp;Nicoletta Colombo MD, PhD ,&nbsp;Margarita Romeo Marin MD, PhD ,&nbsp;Regina Berger PhD ,&nbsp;Emma Fields MD ,&nbsp;Karla Alejandra Lopez MD ,&nbsp;Vincent Castonguay MD ,&nbsp;Kazuhiro Takehara MD, PhD ,&nbsp;Ting-Chang Chang MD ,&nbsp;Domenica Lorusso MD, PhD","doi":"10.1016/j.brachy.2024.08.087","DOIUrl":"10.1016/j.brachy.2024.08.087","url":null,"abstract":"<div><h3>Purpose</h3><div>ENGOT-cx11/GOG-3047/KEYNOTE-A18 (NCT04221945) evaluated pembro + CCRT in patients (pts) with high-risk LACC.</div></div><div><h3>Materials and Methods</h3><div>Pts with previously untreated, high-risk LACC (FIGO 2014 stage IB2‒IIB with node-positive disease or stage III‒IVA) were randomized 1:1 to receive 5 cycles of pembro 200 mg or placebo (pbo) Q3W + CCRT then 15 cycles of pembro 400 mg or pbo Q6W. CCRT was 5 cycles (optional 6th dose) of cisplatin 40 mg/m² QW + EBRT then brachytherapy. Primary endpoints were PFS per RECIST v1.1 by investigator or histopathologic confirmation and OS.</div></div><div><h3>Results</h3><div>1060 pts were randomized to pembro + CCRT (n = 529) or pbo + CCRT (n = 531). At IA1 (data cutoff: Jan 9, 2023), median follow-up was 17.9 mo. Pts received a median of 11 cycles of pembro or pbo and 5 cycles of cisplatin in both arms. Most pts completed radiation treatment (pembro + CCRT, 97.9%; pbo + CCRT, 98.3%); overall median treatment duration was 52 d in both arms. Table 1 summarizes the CCRT treatment. Pembro + CCRT improved PFS vs pbo + CCRT (HR 0.70 [95% CI 0.55‒0.89]; <em>P</em> = 0.0020). Median PFS was not reached in either arm. PFS benefit was generally consistent across prespecified subgroups. With only 103 events (42.9% maturity), pembro + CCRT had a favorable trend in OS (HR 0.73 [95% CI 0.49‒1.07]). Treatment-related AEs (TRAEs) were less common in the pembro monotherapy phase (72.7%) vs pembro + CCRT combination therapy phase (94.5%); results in the pbo arm were 60.0% vs 95.7%. Safety profiles were consistent with the known profiles of pembro monotherapy and chemoradiotherapy.</div></div><div><h3>Conclusions</h3><div>Pembro + CCRT showed a statistically significant and clinically meaningful improvement in PFS and a favorable trend in OS vs pbo + CCRT in pts with high-risk LACC. Pembro + CCRT had manageable safety, with most TRAEs occurring during the combination phase of therapy. Pembro + CCRT has potential as a new standard of care for this high-risk population.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527288","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":"Thursday, July 11, 20249:00 AM - 10:00 AMGPP01 Presentation Time: 9:00 AM","authors":"Memory Fadziso Bvochora-Nsingo Masters in Medicine,&nbsp;Dawn Balang MD","doi":"10.1016/j.brachy.2024.08.003","DOIUrl":"10.1016/j.brachy.2024.08.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The study's purpose was to evaluate the ASARA (As Simple As Reasonably Available) method for providing high-quality brachytherapy amidst substantial resource constraints, focusing on a sole radiation therapy center in Botswana. This setting reflects Sub-Saharan Africa's broader challenges, such as high cervical cancer rates and limited healthcare resources, including scarce personnel, minimal equipment, and lack of advanced infrastructure like MRI scanners. The research sought to describe a scalable, innovative cancer care model suitable for low-resource settings. Implementing the ASARA approach could revolutionize cervical cancer treatment in areas where traditional HDR brachytherapy faces logistical and financial barriers, aiming to lower cervical cancer morbidity and mortality across the region.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;The study adopted an observational design of over 1200 patients undergoing brachytherapy with the ASARA method. Key strategies included: scheduling to optimize limited instrument availability, utilizing digital vaginal and speculum examinations to compensate for the absence of pre-treatment radiological imaging, employing conscious sedation in lieu of general anesthesia, replacing ultrasound-guided insertion with a uterine sound, improvising immobilization techniques, and leveraging online resources for training and capacity building. All planning was CT- based.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In 2022 to 2023, the ASARA method facilitated 1,200 brachytherapy procedures, demonstrating its effectiveness in a busy clinical environment. The team typically comprised an oncologist, a nurse, a healthcare assistant, a radiation therapist, and a physicist. A strategic scheduling and rotation system for instruments reduced the need for frequent sterilization, enabling up to five procedures daily within an eight-hour shift. Patient readiness and instrumentation choice were assessed via digital examinations, with sedation customized to each patient, avoiding general anesthesia. Pain management included pethidine, oral morphine, diclofenac, benzodiazepines, and paracetamol. Ultrasound was not used for tandem insertions, with a uterine sound minimizing perforation risks. CT guidance was crucial for accurate interstitial placements, with basic immobilization techniques ensuring precision.(Fig 1). The success rate was high at 95%, with a low complication rate of 0.75%, comparable to well-resourced settings, and there were no significant differences in immediate post-treatment complications or short-term clinical outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The ASARA method offers a practical solution for delivering brachytherapy in resource-constrained settings without compromising on treatment quality. By effectively utilizing available resources, embracing innovative strategies, and harnessing digital training platforms, it enables the provision of vital cancer care to underserve","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526708","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":"MSOR7 Presentation Time: 5:30 PM","authors":"Daya Nand Sharma MD,&nbsp;Surendra Kumar Saini MD,&nbsp;Vellaiyan Subramani PhD","doi":"10.1016/j.brachy.2024.08.041","DOIUrl":"10.1016/j.brachy.2024.08.041","url":null,"abstract":"<div><h3>Purpose</h3><div>High-dose-rate interstitial brachytherapy (HDR-IBT) is a favored treatment option over partial penectomy in patients with T1-T2 stage penile carcinoma due to its organ preservation capability. There are limited studies on HDR-IBT in the literature. We analyzed the data of patients of early-stage penile cancer treated with HDR-IBT alone at our center.</div></div><div><h3>Methods and Materials</h3><div>Between April 2010 and March 2019, 32 patients with T1-T2 stage penile carcinoma were treated with HDR-IBT at our center. Size of the primary lesion ranged from 1.5 cm to 4.0 cm. A free hand implant was performed using plastic catheters in 2-4 planes. The prescription dose of HDR-IBT was 42-51 Gy in 14-17 fractions (twice a day fractionation schedule). Patients were followed up regularly for assessment of local control, survival, toxicity and sexual function.</div></div><div><h3>Results</h3><div>At a median follow up of 52 months, 6 patients developed recurrent disease at loco-regional site. The 5-year overall survival (OS) was 81% with penis preservation rate (PPR) of 85%. Meatal stenosis was the commonest long-term complication observed in 16 patients. Fifteen of them were managed by frequent urethral dilatations and one patient required temporary suprapubic cystostomy. Eighteen patients had satisfactory sexual function status at the last follow up visit.</div></div><div><h3>Conclusions</h3><div>The long-term results of our study have demonstrated excellent local control rate and acceptable toxicity with HDR-IBT in patients with T1-2 stage penile carcinoma.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142526612","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":"PL03 Presentation Time: 2:00 PM","authors":"Memory Fadziso Bvochora-Nsingo Masters in Medicine,&nbsp;Elliphine Gwangwava Masters in Physics,&nbsp;Thabiso Itsbeng Masters in Physics","doi":"10.1016/j.brachy.2024.08.061","DOIUrl":"10.1016/j.brachy.2024.08.061","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;Cervical cancer is the most common cancer treated in Botswana, and the number one cause of cancer related deaths. Curative treatment consists of concurrent chemoradiation with brachytherapy boost . Until 2011, the absence of brachytherapy services in Botswana necessitated patient referrals to South Africa following external beam radiation. Our objective was to establish and consistently deliver high-quality radiation therapy within Botswana to enhance treatment outcomes. A significant challenge was the shortage of locally experienced personnel in High Dose Rate (HDR) brachytherapy, prompting us to engage global experts throughout the endeavor. This study aims to assess the sustainance and advancement of brachytherapy utilization in Botswana over a 12-year period since its implementation, and evaluate the impact of global collaboration on its integration into the country's healthcare system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;A retrospective analysis was conducted utilizing healthcare records, collaborative initiatives, and interviews with key stakeholders involved in brachytherapy provision. Quantitative data and qualitative insights were combined to understand the evolution of brachytherapy services in Botswana.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Brachytherapy services commenced in Botswana in 2012, following the establishment of local government support, private-public partnerships, and vendor training in 2011. To date, over 6000 successful implants have been done on at least 2000 patients. Collaborative efforts, particularly through Massachusetts General Hospital faculty under the BOTSOGO (Botswana Global Oncology Outreach) initiative, and Botswana-Upenn partnership, led to significant progress, beginning with the introduction of 2D and eventually 3D CT-guided to interstitial brachytherapy techniques. The pivotal on-site training session conducted by a multidisciplinary team from MGH in February 2012, comprising expert oncologists, physicists, therapists, and managers, laid the foundation for future collaborations and instilled confidence within the local team. Further collaborations included bilateral exchanges, support with data collection, presentation at conferences and continuing education. Figure 1 illustrates the increase in brachytherapy utilization over the 12-year period, and the input from collaborators.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Collaborative efforts between local and international stakeholders have significantly advanced brachytherapy utilization in Botswana, progressing from zero provision to advanced CT-guided techniques. This progress is attributed to sustained global collaboration efforts, including enhanced training programs, infrastructure development, and resource allocation. Continued collaboration builds confidence in the local team with construed peer review and upskilling. Positive patient outcomes and increased healthcare access have been observed as a result o","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527200","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":"PP02 Presentation Time: 4:09 PM","authors":"Andre Karius (Dr.),&nbsp;Lisa Marie Leifeld M.Sc.,&nbsp;Vratislav Strnad (Prof. Dr.),&nbsp;Rainer Fietkau (Prof. Dr.),&nbsp;Christoph Bert (Prof. Dr.)","doi":"10.1016/j.brachy.2024.08.021","DOIUrl":"10.1016/j.brachy.2024.08.021","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To enable a real-time applicator navigation and guidance for brachytherapy, we used a novel prototype infra-red tracking camera system directly integrated into a mobile cone-beam computed tomography (CBCT) scanner for the first time. We provide the first characterization of the combined device and a corresponding performance evaluation, assessed the respective tracking accuracy, and implemented a prediction of needle courses and tips on CBCT scans based on the infra-red tracking.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Methods&lt;/h3&gt;&lt;div&gt;We conducted a comprehensive assessments of the system's camera calibration and camera-CBCT registration by means of dedicated phantoms. For this, we first evaluated the effects of intrinsic parameters such as temperature or source/detector gantry positions on the positions of the tracked markers. Afterwards, calibrations with various setting (sample number, field of view coverage, calibration directions, calibration distances, and light conditions) were conducted to determine the setting-requirements for achieving maximum tracking quality based on an in-house phantom. The corresponding effects on camera-CBCT registration were also determined by comparing markers tracked and measured via CBCT. Long-term stability was assessed by comparing tracking and a ground-truth weekly for six weeks. Furthermore, a marker-tool rigidly attachable to needles was 3D printed. The respective tool tracking precision and accuracy was evaluated for stationary settings as well as dynamic movements. Moreover, we evaluated Euclidean deviations between tracked markers and marker positions determined via CBCT. For implementing needle tracking, ground-truth models of the tool attached to needles of 200mm and 160mm length were first created and then matched onto the tracked positions, aiming to project the needle courses into CBCT scans. Deviations between projected and actual needle tips were measured. Finally, we put our results into perspective regarding simulations of the devices's tracking uncertainties.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Robust and reliable tracking was feasible after a 100 min warm-up period using the tracking system ‘as is’, with positional variations of only 0.11±0.10 mm. Gantry rotations impacted the tracking procedure and led to inaccuracies of up to 0.70 mm. We identified 4000 samples and full coverage to be required for ensuring an optimum marker tracking and camera-CT registration with geometric variations of only 0.18±0.03 mm and 0.42±0.07 mm, respectively. Nevertheless, long-term stability analyses revealed geometric variations larger than two standard deviations compared to the initial calibration occurring after only 3 weeks. For the stationary settings and dynamic movements, we achieved a tool tracking precision and accuracy of 0.04±0.06 mm and 0.16±0.18 mm, respectively. Tracked marker positions deviated by 0.57±0.18mm from the marker positions identified via CBCT. Moreover, predicted","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527066","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":"Brachytherapy based microboosting to the dominant intraprostatic lesion in prostate cancer: A systematic review on treatment outcomes and toxicities","authors":"Mehdi Kazemi ,&nbsp;Andrew Barsoum ,&nbsp;Katelyn M. Atkins ,&nbsp;Leslie Ballas ,&nbsp;Mitchell Kamrava","doi":"10.1016/j.brachy.2024.06.002","DOIUrl":"10.1016/j.brachy.2024.06.002","url":null,"abstract":"<div><h3>PURPOSE</h3><p>Whether brachytherapy based microboosting of the dominant intraprostatic lesion (DIL) improves outcomes over standard approaches is not known. The purpose of this study is to perform a systematic review on brachytherapy microboosting of the DIL to evaluate clinical outcomes and toxicities with this treatment approach.</p></div><div><h3>MATERIALS And METHODS</h3><p>This review was performed according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Databases including Pubmed, Embase, and Google Scholar were queried. About 16 studies met our inclusion criteria. These studies reported PSA control and/or toxicities based on standardized scales.</p></div><div><h3>RESULTS</h3><p>There were 10 studies (two monotherapy, eight combination) that used HDR microboosting on a total of 516 patients. HDR dose (EQD2 assuming alpha/beta of 1.5) to the DIL ranged from 90 to 180 Gy. Most patients were low/intermediate risk. PSA control rates at 5–8 years ranged from 69% to 100%. Acute/late G3-G4 GU/GI toxicities ranged from 0% to 12%. There were six studies (five monotherapy, one combination) that used LDR microboosting on a total of 1041 patients. Studies performed a microboost of 130–150% of the whole gland prescription to the DIL. Most patients were low/intermediate risk. PSA control rates at 5 years ranged from 69% to 98%. Acute/late G3–4 GU/GI toxicities ranged from 0% to 4%.</p></div><div><h3>CONCLUSIONS</h3><p>Over 1000 patients have been treated with a brachytherapy based microboost in published series. Severe acute/late toxicities appear limited. PSA control rates with more than 5 years of follow-up are limited. Longer-term follow-up is needed to determine ideal utilization of this approach.</p></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857391","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":"CT-guided iodine-125 brachytherapy is an effective palliative treatment for the right lower paratracheal lymph nodes metastasis previously treatment failure","authors":"Hang Yuan,&nbsp;Ho-Young Song,&nbsp;Hong-Tao Hu,&nbsp;Hong-Tao Cheng,&nbsp;Hai-Liang Li","doi":"10.1016/j.brachy.2024.06.009","DOIUrl":"10.1016/j.brachy.2024.06.009","url":null,"abstract":"<div><h3>PURPOSE</h3><p>This study aimed to evaluate the effectiveness and safety of iodine-125 brachytherapy as a treatment for right lower paratracheal lymph node metastasis following unsuccessful prior therapies.</p></div><div><h3>METHODS</h3><p>A retrospective review of patients who underwent iodine-125 brachytherapy for right lower paratracheal lymph node metastasis was conducted. The study included 24 patients who met the predefined criteria. Iodine-125 seeds were implanted under CT guidance, and treatment planning was performed using a treatment planning system. The primary endpoint was the objective response rate (ORR), while overall survival (OS) and complications were secondary endpoints.</p></div><div><h3>RESULTS</h3><p>The ORR was 87.5%, with 4 patients achieving complete response (CR) and 17 patients achieving partial response (PR). The mean diameter of metastatic lymph nodes significantly reduced from 40.21 ± 6.66 mm before treatment to 12.25 ± 9.27 mm at the last follow-up (<em>p</em> &lt; 0.001). The median OS was 14.70 months, with 1-year and 2-year survival rates of 78.9% and 20.9%, respectively. Clinical symptoms significantly improved, as indicated by increased Karnofsky Performance Score (KPS) scores. Complications were manageable, with no procedure-related deaths.</p></div><div><h3>CONCLUSION</h3><p>Iodine-125 brachytherapy demonstrated promising efficacy and safety as an alternative treatment for right lower paratracheal lymph node metastasis after unsuccessful prior therapies.</p></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1538472124001077/pdfft?md5=a45f57c27eae2db31500d7968175b442&pid=1-s2.0-S1538472124001077-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857392","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 and promotion of a 3D-printed phantom model for ultrasound-guided caudal block followed by intracavitary/interstitial brachytherapy for gynecological cancer","authors":"Terufumi Kawamoto ,&nbsp;Masaki Oshima ,&nbsp;Naoya Murakami,&nbsp;Noriyuki Okonogi,&nbsp;Yoichi Muramoto,&nbsp;Tatsuki Karino,&nbsp;Kotaro Iijima,&nbsp;Jun Takatsu,&nbsp;Tatsuya Inoue,&nbsp;Naoto Shikama","doi":"10.1016/j.brachy.2024.05.006","DOIUrl":"10.1016/j.brachy.2024.05.006","url":null,"abstract":"<div><h3>PURPOSE</h3><p>We developed a 3D-printed phantom model for ultrasound-guided caudal block for educational or training purposes because there have been no reports of the 3D-printed phantom model for ultrasound-guided caudal block. This study aimed to identify the needs for the phantom model in a lecture and demonstration at hands-on training (HoT) to promote the use of caudal block for sufficient pain control during high-dose-rate intracavitary/interstitial brachytherapy for gynecological cancers.</p></div><div><h3>MATERIALS AND METHODS</h3><p>The sacrum and formwork were designed by computed tomography imaging. A 3D-modeling software program was used to create the sacrum and formwork. The phantom was solidified by injecting a gelatin-based gel. Ultrasonography was performed to visualize the sacral hiatus and puncture needle in the phantom. In October 2023, 10 radiation oncologists who did not perform caudal block in daily clinical practice from ten Japanese facilities participated in HoT on ultrasound-guided caudal block. After the HoT, questionnaires were distributed to each participant, and feedback was obtained through online channels.</p></div><div><h3>RESULTS</h3><p>After receiving a lecture and demonstration on ultrasound-guided caudal block, 90% of the respondents would like to practice the procedure in their daily clinical practice. Moreover, 100% of the respondents would like to use the 3D-printed phantom model for ultrasound-guided caudal block for educational or training purposes.</p></div><div><h3>CONCLUSION</h3><p>The 3D-printed phantom model for ultrasound-guided caudal block can be used in training and is in demand for facilities introducing caudal block.</p></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141790263","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}