Brachytherapy最新文献

{"title":"3D HDR brachytherapy for cervical cancer in LMIC: Audit of a single institution experience in Lagos, Nigeria","authors":"Adedayo Joseph ,&nbsp;Chika Nwachukwu ,&nbsp;Bolanle Adegboyega ,&nbsp;Omolola Salako ,&nbsp;Temitope Andero ,&nbsp;Adewumi Alabi ,&nbsp;Azeezat Ajose ,&nbsp;Samuel Adeneye ,&nbsp;Nusirat Adedewe ,&nbsp;Abdallah Kotkat ,&nbsp;Aishat Oladipo ,&nbsp;Omoruyi Credit Irabor ,&nbsp;Muhammad Habeebu ,&nbsp;David Puthoff ,&nbsp;Adedayo Onitilo ,&nbsp;Wilfred Ngwa ,&nbsp;Onyinye Balogun","doi":"10.1016/j.brachy.2025.01.007","DOIUrl":"10.1016/j.brachy.2025.01.007","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>The first 3D high-dose-rate brachytherapy (3D-HDR-BT) program for gynecological cancers in Lagos, Nigeria, was launched in August 2021. A retrospective audit of the pilot program was conducted to report the institution's initial experience in treating cervical cancer within the framework of the American Brachytherapy Society (ABS) guidelines.</div></div><div><h3>METHODS AND MATERIALS</h3><div>24 patients were audited and divided into 2 groups: Group A, which included the first twelve (who had been treated within 3 months of the program launch), and Group B, which included the next twelve (who received treatment over a subsequent period of 5 months).</div></div><div><h3>RESULTS</h3><div>The average age was 58.04 years, with the most common stage at presentation being FIGO Stage IIB (50%). Squamous cell carcinoma was the prevalent histologic type (87.5% of cases). The predominant EBRT regimen was 1.8Gy x 25 fractions in 66.67% of patients. For brachytherapy, 62.5% received the 8Gy x 3 fractions regimen. All patients received weekly concurrent chemotherapy with external beam radiation, with the majority getting cisplatin monotherapy during external beam radiotherapy (EBRT). The mean dose to D90 of the HR-CTV was 77.48 ± 6.95Gy and 88.93 ± 4.20Gy in Group A and B patients, respectively. A comparative assessment revealed significant improvement in HRCTV D90 doses for Group B patients.</div></div><div><h3>CONCLUSION</h3><div>We report evident improvement in HRCTV D90 doses with increasing numbers and duration of practice, indicating that team proficiency improves with an increasing number of patients treated. Future studies will focus on overall survival and local control rates among patients treated on the program.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 4","pages":"Pages 479-485"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033999","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":"Long-term rectal patient-reported quality of life outcomes among patients treated with Pd-103 LDR prostate brachytherapy","authors":"Keara English ,&nbsp;Tanmay Singh ,&nbsp;Michael Roumeliotis ,&nbsp;Ulysses Grant Gardner ,&nbsp;Gayane Yenokyan ,&nbsp;Emerson Lee ,&nbsp;Todd McNutt ,&nbsp;Theodore DeWeese ,&nbsp;Daniel Y Song","doi":"10.1016/j.brachy.2025.02.003","DOIUrl":"10.1016/j.brachy.2025.02.003","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;PURPOSE&lt;/h3&gt;&lt;div&gt;Rectal toxicity is a dose-limiting side effect of definitive prostate radiation. There are limited long-term data on patient-reported rectal toxicity outcomes following Pd-103 LDR prostate brachytherapy, as well as some recent data suggesting high rates of long-term toxicity from LDR brachytherapy overall. This study reports incidence and predictors of late patient-reported rectal quality of life outcomes after Pd-103 prostate brachytherapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;MATERIALS AND METHODS&lt;/h3&gt;&lt;div&gt;This study analyzed a prospectively collected IRB-approved database of men receiving LDR prostate brachytherapy between 12/2004 and 12/2018 at our institution. Patients received either LDR monotherapy or combined with IMRT to prostate and/or pelvic lymph nodes. Outcomes data related to rectal toxicity were evaluated based on Bowel subdomain of the Epic-26 questionnaire, which was routinely given to patients at initial consult and follow up visits. Bowel “Bother” score (“How big a problem have your bowel habits been during the last 4 weeks”) was analyzed for overall bowel function assessment. Patients were grouped into those reporting ‘Moderate Problem’ or worse and those reporting ‘No, Very Small, or Small’ problem. In addition, composite Function and Bother scores were analyzed. Statistical analyses assessed the correlation between the V100% (volume of rectum receiving 100% of the prescription dose) and patient Function and Bother QOL scores over time using linear mixed models with random intercept for patient.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;146 patients met criteria and were included in the analyses; 51 (35%) received combined IMRT 45 Gy with Pd-103 (90-100 Gy) and 95 (65%) patients received Pd-103 monotherapy (125 Gy). There were 863 individual responses to the Bowel problem questions completed. Median follow-up with questionnaire data was 4.7 years; 102/146 (70%) patients had follow-up greater than 2 years, and 70/146 (48%) greater than 5 years. Among 814 questionnaires with “Bother” question completed, the proportion of patients reporting ‘No / Very Small / Small Problem’ was 97.3% pretreatment, and 92.5% at last follow-up. Proportion of ‘Moderate or Big Problem’ responses at any time during follow-up was 4.8%. At last recorded follow-up, Mean Bother score was 89.1 (SD 14.4) in patients receiving IMRT + LDR, n = 48, and 91.2 (SD 13.4), n = 95 in LDR monotherapy patients (&lt;em&gt;p&lt;/em&gt; = 0.39).&lt;/div&gt;&lt;div&gt;Neither follow-up time nor Prostate V100 were independently associated with Bother score (&lt;em&gt;p&lt;/em&gt; = 0.15 and 0.71, respectively). In multivariable linear mixed model, IMRT was not statistically associated with Bother score adjusted for Rectal V100 and follow-up time (&lt;em&gt;p&lt;/em&gt; = 0.16), nor was it associated with Epic Function Score (&lt;em&gt;p&lt;/em&gt; = 0.6).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;CONCLUSIONS&lt;/h3&gt;&lt;div&gt;Patients receiving Pd-103 brachytherapy with or without IMRT reported excellent preservation of long-term bowel quality of life. IMRT","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 4","pages":"Pages 524-529"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775161","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":"Hands-on training using human cadavers: An educational method for head and neck brachytherapy","authors":"Monali Swain ,&nbsp;Ashwini Budrukkar ,&nbsp;Elena Dizendorf ,&nbsp;Suman Ghosh ,&nbsp;Uday Bhat ,&nbsp;Sarbani Ghosh Laskar ,&nbsp;Samarpita Mohanty ,&nbsp;Anuj Kumar ,&nbsp;Shwetabh Sinha ,&nbsp;Rituraj Upreti ,&nbsp;Shrikant Kale ,&nbsp;Priyadarshini Sahoo ,&nbsp;Jai Prakash Agarwal","doi":"10.1016/j.brachy.2025.02.004","DOIUrl":"10.1016/j.brachy.2025.02.004","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To report the impact of didactic lectures with hands-on cadaveric training for head and neck brachytherapy (BT) as part of a teaching course.</div></div><div><h3>MATERIALS AND METHODS</h3><div>The 1st BT teaching course under Elekta BrachyAcademy for head and neck cancer (HNC) and breast cancer was conducted at Tata Memorial Hospital, Mumbai, India. Didactic lectures with cadaveric workshop and hands-on training for planning procedure were taught to the participants. Both precourse survey and postcourse evaluation were conducted.</div></div><div><h3>RESULTS</h3><div>Total 33 radiation oncologists (ROs) and seven medical physicists were trained. The major goals of participating in the master course were to increase confidence in performing brachytherapy and to begin practicing it, as indicated by 23 and 20 responses, respectively. Nine ROs were already doing the BT for HNC, 18 participants were willing to start HN BT procedure within 1year from the training course and five participants did not have the necessary equipment in the postcourse evaluation, 95% and 94% of participants acknowledged adequate coverage of the scope of the topic and the clarity of the content, respectively, as very good or good (5 or 4) in a scale of 5. The training course met the expectation of 94% of the participants. The hands-on training on cadavers for buccal mucosa cancer was considered as very good by 96% of participants and was most useful and needed. One participant insisted on the lacuna of systematic training program for BT in India.</div></div><div><h3>CONCLUSIONS</h3><div>Didactic training with hands-on procedure led to increase in confidence and appears to be one of the suitable methods for training HN BT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 4","pages":"Pages 530-535"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055176","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 novel technique of brachytherapy for carcinoma of the buccal mucosa—Thinking out of the box!","authors":"Tanvir Pasha ,&nbsp;Nikhila Radhakrishna ,&nbsp;Rekha Reddy Buchapudi ,&nbsp;Rashmi Shivananjappa ,&nbsp;Pushpa Kothakapu ,&nbsp;Naveen Thimmaiah","doi":"10.1016/j.brachy.2025.04.003","DOIUrl":"10.1016/j.brachy.2025.04.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Brachytherapy(BT) can be used alone or in conjunction with external beam radiotherapy (EBRT) in the management of early head and neck cancers. Technical challenges may be encountered while planning implants for buccal mucosal cancers, which require customized solutions. We present the design and application of a customized 3D printed template for brachytherapy in one such case.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A 68 year old lady with an exophytic verrucous lesion of 2.5 × 2 cm in her left buccal mucosa refused to undergo surgical excision. She was planned for definitive Brachytherapy. The lesion being placed posteriorly and superiorly had a close proximity to the retromolar trigone and the upper gingivobuccal sulcus. This posed a technical challenge to place the implant in the regular parallel fashion, especially to provide adequate posterior and superior margins. Hence a perpendicular template based implant was planned.</div><div>Three-dimensional (3D) Printing technology allows the creation of 3D physical objects from digital models using the additive manufacturing technology. A new template was created using 3D print technology customized to the patient's anatomy, to guide the placement of catheters in congruence with the Paris system of implant rules.</div></div><div><h3>RESULTS</h3><div>Patient tolerated the treatment well and had grade three mucositis patch replacing the lesion at 3 weeks post treatment. At 3 months, she had a complete response with no xerostomia and minimal hyperpigmentation of overlying skin at catheter entry points. She is currently on follow-up at 1 year with no clinical or radiological evidence of disease.</div></div><div><h3>CONCLUSIONS</h3><div>Radical Brachytherapy offers excellent outcomes in early buccal mucosal lesions. Customized templates may be created using 3D printing to perform ISBT in Head and Neck Cancers in technically difficult cases.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 4","pages":"Pages 536-542"},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251299","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":"Gastrointestinal and genitourinary toxicity following high dose rate vaginal cuff brachytherapy for endometrial cancer","authors":"Niki Tselepidakis ,&nbsp;Ruyun Jin ,&nbsp;Bethany Horton ,&nbsp;Wendy Zheng ,&nbsp;Einsley Marie Janowski ,&nbsp;Kara Romano","doi":"10.1016/j.brachy.2025.02.005","DOIUrl":"10.1016/j.brachy.2025.02.005","url":null,"abstract":"<div><h3>PURPOSE</h3><div>There are currently no organs at risk dose constraints for adjuvant HDR vaginal cuff brachytherapy (VBT). This study evaluates OAR dosimetry and the association with acute and chronic gastrointestinal (GI) or genitourinary (GU) toxicity.</div></div><div><h3>METHODS</h3><div>Patients treated at a single institution with VBT of 21 Gray (Gy) in 3 fractions (Fx) prescribed to 5 mm depth twice weekly and CT-based 3D planning were reviewed. OAR doses (D2cc, D1cc, and D0.1cc) were recorded. Acute and chronic toxicities were graded by Common Terminology Criteria for Adverse Events v5.0. Boxplot and Wilcoxon–Mann–Whitney tests compared dose thresholds.</div></div><div><h3>RESULTS</h3><div>177 patients with stage I–IV endometrial cancer received a mean D2cc to rectum, sigmoid, small bowel, and bladder of 5.7 Gy (range: 2.8–8.7), 3.3 Gy (0.6–9.3), 3.8 Gy (0.0–9.1), and 5.4 Gy (2.0–8.2). Overall, 6.2% (<em>n</em> = 11) and 7.3% (<em>n</em> = 13) of patients experienced acute GI and GU toxicity of any grade. 14.7% (<em>n</em> = 26) and 14.7% (<em>n</em> = 26) of patients experienced chronic GI and GU toxicity of any grade, respectively. There were two grade 3 toxicities include one chronic GI and one acute GU. No dosimetric factors were identified that correlated with a higher likelihood of acute or chronic toxicity.</div></div><div><h3>CONCLUSIONS</h3><div>The overall rate of GI and GU toxicity following VBT of 21 Gy in 3 Fx is low, and there are no dosimetric parameters that correlate with toxicity. The optimal dose fractionation schedule that balances high local control with minimal toxicity is yet to be determined</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 389-394"},"PeriodicalIF":1.7,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694832","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":"Outcomes and dosimetric analysis of reirradiation of oral cavity and oropharyngeal cancers with high-dose-rate brachytherapy","authors":"Christina Phuong,&nbsp;Lisa Ni,&nbsp;Manju Sharma,&nbsp;J. Adam M Cunha,&nbsp;Sue S. Yom,&nbsp;I-Chow Hsu,&nbsp;Jason W. Chan","doi":"10.1016/j.brachy.2025.02.002","DOIUrl":"10.1016/j.brachy.2025.02.002","url":null,"abstract":"<div><h3>PURPOSE</h3><div>This study sought to evaluate the outcomes and toxicities from oral cavity (OC) and oropharynx (OP) high-dose-rate brachytherapy (HDRBT) for re-irradiation (reRT) of head and neck squamous cell carcinoma (HNSCC).</div></div><div><h3>METHODS</h3><div>Patients who previously received curative-intent external beam radiotherapy for primary HNSCC and were treated with OC/OP reRT with HDRBT from January 2000 to December 2021 were included. Patients were selected by a multidisciplinary tumor board to be appropriate candidates for HDRBT for one of two reRT indications: (1) definitive reRT or (2) postoperative reRT. Survival outcomes were estimated using the Kaplan-Meier method. Efficacy and toxicity outcomes were analyzed for the entire cohort and separately based on reRT indication.</div></div><div><h3>RESULTS</h3><div>27 patients were evaluated with a median follow up of 20 (IQR 12-41) mo. 14 (52%) and 13 (48%) patients were treated for a recurrent or second primary OC and OP HNSCC, respectively. Median dose of prior EBRT was 68.4 (IQR 60-70) Gy. Median interval between completion of EBRT to HDRBT reRT was 42 (IQR 14-85) mo. Median target volume was 16 (IQR 10-29) cc; median D90% was 31 (IQR 30-36) Gy. In cohorts A and B, 2-year LC/late grade ≥3 toxicity were 70%/57% and 60%/15%, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>HDRBT for reRT of small (&lt;4 cm), recurrent, or second primary OC/OP HNSCC provided LC and late grade ≥3 toxicity rates similar to historical outcomes with EBRT reRT.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 413-419"},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674889","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-Tailored Anal canal Radiotherapy (HIT-ART): Long term results of MR image-guided interventional radiotherapy (brachytherapy) boost","authors":"Luca Tagliaferri ,&nbsp;Stefania Manfrida ,&nbsp;Bruno Fionda ,&nbsp;Nicola Dinapoli ,&nbsp;Brunella Barbaro ,&nbsp;Viola De Luca ,&nbsp;Elisa Placidi ,&nbsp;Roberta Bertolini ,&nbsp;Fabio Marazzi ,&nbsp;Valentina Lancellotta ,&nbsp;Vincenzo Frascino ,&nbsp;Alessio Giuseppe Morganti ,&nbsp;Maria Antonietta Gambacorta","doi":"10.1016/j.brachy.2025.01.006","DOIUrl":"10.1016/j.brachy.2025.01.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The aim of this study is to investigate the outcomes in terms of survival, treatment compliance and toxicity in a cohort of patients treated with personalized chemoradiation (RCT) followed by image guided Interventional Radiotherapy (IG-IRT), stratified by clinical baseline stage and treatment response.</div></div><div><h3>METHODS AND MATERIALS</h3><div>We analyzed patients with histologically proven squamous anal carcinoma treated using intensity modulated radiation therapy (IMRT) with curative intent, and IRT boost. External beam radiation was delivered using personalized IMRT technique with a simultaneous-integrated boost (SIB) to deliver 45 to 55 Gy in 25 fractions according to clinical stage. After the end of the RCT patients underwent clinical and imaging re-evaluation, and according to initial stage of disease and tumor response, a radiotherapy boost was administered through IG-IRT, performing MRI with IRT applicator on site (trans-anal position) and defining GTV on MRI imaging. All patients’ treatments and outcomes data were collected by an internal database. The endpoints were in terms of overall treatment time (OTT), toxicity, clinical complete response (cCR), locoregional failure (LRF), colostomy free survival, overall survival (OS) and disease-free survival (DFS). Univariate survival analysis with Kaplan- Meier curves was performed to allow between-group comparison.</div></div><div><h3>RESULTS</h3><div>73 patients treated between February 2012 and January 2023 were included in the analysis. 72.6 % were female, with a median age of 65.4 years (range 39.1–89). 62 were staged T2-T4 (T2 42.5.5%, T3 19.2%, T4 27.4%) and 50 (68.5%) had positive nodes. Combined RCT was administered mainly using mitomycin C and 5-fluorouracil. The mean dose received by patients was 50 Gy; after a median time of 43 days (range 9-128) a sequential boost dose was delivered in 1-2 fractions (median dose of 4 Gy). OTT median was 85 days (range 44–225). The median follow-up period was 50.6 months. LRF was 17.8%, and at 3 and 5 years LC was 80.1% and 77.2%, CFS was 80.5 and 77.8%, DFS was 79.3% and 75.9% and OS 95.1%, 84.3% and 61.4% at 10 years. Moreover, we verified that OS was higher in patients who had an OTT lower than 93 days. Toxicity was acceptable: 45.2% of patients experienced a G1-G2 abdominal discomfort (only 5.5% had G3).</div></div><div><h3>CONCLUSIONS</h3><div>Our experience confirms that MR Image Guided Interventional Radiotherapy boost is a feasible treatment option with a significant impact on outcomes.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 439-449"},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674869","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":"Implementation of 3D image-guided brachytherapy for penile cancer: Impact of urethral dose on long-term morbidity","authors":"Samir Achkar ,&nbsp;Mouhamadou Bachir ,&nbsp;Rémi Bourdais ,&nbsp;Manon Kissel ,&nbsp;Tony Felefly ,&nbsp;Alexandre Escande ,&nbsp;Sophie Espenel ,&nbsp;Roger Sun ,&nbsp;Cyrus Chargari","doi":"10.1016/j.brachy.2024.02.007","DOIUrl":"10.1016/j.brachy.2024.02.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Interstitial brachytherapy is a conservative treatment approach for localized penile glans cancer. We report our experience with pulse dose rate interstitial brachytherapy (PDR-BT) in the treatment of penile cancer and evaluated urethral dose-volume constraints for clinical practice.</div></div><div><h3>Methods and materials</h3><div>Medical records of patients treated with PDR-BT for localized squamous cell carcinoma of the glans penis in our institution between July 2008 and February 2019 were reviewed. All patients underwent posthectomy followed by CT-guided PDR-BT. Urethral doses were calculated and predictors of urethral stenosis among various clinical and dosimetric characteristics were examined.</div></div><div><h3>Results</h3><div>65 patients were identified. Eight patients (12%) presented initially with inguinal lymph node metastasis. The median brachytherapy dose was 60 Gy (37–65 Gy). The median number of pulses was 150 pulses (87–175 pulses). With a median follow-up of 37 months (3–120 months), 12 patients (18.4%) had tumor local relapse. Three-year overall survival (OS) and disease-free survival (DFS) rates were 88.2% (95%CI: 79.7–97.7%) and 74.4% (95%CI: 63.9–86.6%) respectively. Twelve patients (20%) presented grade 2 painful ulceration resolving spontaneously and 13 patients (21.5%) experienced grade 2 meatal stenosis. No clinical or dosimetric factors correlated with painful ulceration were identified. The risk of meatal stenosis correlated with distal urethra D0.1cc (<em>p</em> = 0.0016) and D0.2cc (<em>p</em> = 0.0019) in multivariate analysis. The optimal cutoff for these constraints were 82 Gy (HR = 0.12, 95%CI: 0.04–0.38) and 79 Gy (HR = 0.19, 95%CI: 0.06–0.56) for D0.1 cc and D0.2 cc respectively.</div></div><div><h3>Conclusions</h3><div>This institutional experience shows that 3D PDR-BT could be a valid option for penile preservation. Dosimetric constraints for late distal urethral toxicity were identified.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 395-403"},"PeriodicalIF":1.7,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588824","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":"Intraluminal brachytherapy using 125I seed strand combined with PTBD and Hepatic arterial infusion chemotherapy for unresectable Bismuth-Corlette III and IV stage hilar cholangiocarcinoma","authors":"Zi-Han Zhang ,&nbsp;Min Li ,&nbsp;Hui-Yi Sun ,&nbsp;Fei-Hang Wang ,&nbsp;Min-Jie Yang ,&nbsp;Zhi-Ping Yan ,&nbsp;Fu-You Li ,&nbsp;Ling-Xiao Liu","doi":"10.1016/j.brachy.2024.12.004","DOIUrl":"10.1016/j.brachy.2024.12.004","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate the safety and efficacy of ¹²⁵I seed strand combined with percutaneous transhepatic biliary drainage (PTBD) and hepatic arterial infusion chemotherapy (HAIC) for unresectable Bismuth–Corlette III and IV stage hilar cholangiocarcinoma (HCCA).</div></div><div><h3>METHODS</h3><div>From January 2018 to December 2021, a total of 128 Bismuth–Corlette III and IV stage HCCA patients with obstructive jaundice were included in this single-center retrospective study. Forty-eight patients underwent ¹²⁵I seed strand combined with PTBD and HAIC (group A). The mean intended dose (<em>r</em> = 10 mm; <em>z</em> = 0; 240 days) in group A was 63.8 ± 0.6 Gy. Eighty cases underwent PTBD plus HAIC (group B). Median overall survival (OS) and median bile duct patency time (BDPT) were compared between the two groups.</div></div><div><h3>RESULTS</h3><div>In the propensity-score matched (PSM) cohort, the median OS and median BDPT were significantly longer in group A than in group B (44 PSM pairs; OS, 13.6 ± 0.4 vs. 8.7 ± 1.4 months, <em>p</em> &lt; 0.001; BDPT, 12.1 ± 0.5 vs. 6.4 ± 0.7 months, <em>p</em> &lt; 0.001). Multivariate analysis revealed that the treatment regimen was an independent prognostic factor of OS. There were no serious complications related to ¹²⁵I seed strand implantation.</div></div><div><h3>CONCLUSIONS</h3><div>¹²⁵I seed strand combined with PTBD and HAIC for unresectable Bismuth–Corlette III and IV stage HCCA is safe and effective.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 3","pages":"Pages 431-438"},"PeriodicalIF":1.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574936","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":"Development and implementation of a 3d-HDR brachytherapy program for cervical cancer in a sub-Saharan African centre","authors":"Adedayo Joseph ,&nbsp;Onyinye Balogun ,&nbsp;Bolanle Adegboyega ,&nbsp;Omolola Salako ,&nbsp;Omoruyi Credit Irabor ,&nbsp;Azeezat Ajose ,&nbsp;Samuel Adeneye ,&nbsp;Adewumi Alabi ,&nbsp;Ephraim Ohazurike ,&nbsp;Chibuzor F. Ogamba ,&nbsp;Aishat Oladipo ,&nbsp;Olufunmilayo Fagbemide ,&nbsp;Muhammad Habeebu ,&nbsp;David Puthoff ,&nbsp;Adedayo Onitilo ,&nbsp;Wilfred Ngwa ,&nbsp;Chika Nwachukwu","doi":"10.1016/j.brachy.2024.10.002","DOIUrl":"10.1016/j.brachy.2024.10.002","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Cervical cancer is the second most common cancer among women in Nigeria where, the gap between need for, and access to, radiation therapy including brachytherapy is significant. This report documents the implementation of the first three-dimensional high-dose-rate (3D-HDR) brachytherapy service for cervical cancer in Nigeria.</div></div><div><h3>PURPOSE</h3><div>This report details the steps taken to implement the 3D-HDR brachytherapy program, the challenges faced, and the adaptive strategies employed to overcome them. Our objective is to provide a guide for teams and centers in similar resource-restricted settings to implement 3D-HDR brachytherapy services, by leveraging our shared experience and lessons learned.</div></div><div><h3>METHOD AND METERIALS</h3><div>The implementation process required investment in infrastructure: creating a dedicated brachytherapy suite equipped with modern technology; and human capital: conducting both virtual and hands-on training for staff; and involving international experts during the initial treatment phases. Quality assurance protocols were established to ensure the accuracy and safety of treatments. Key adaptations included extensive remote training, international experts flying in for the initiation phase, and preemptively re-ordering the radioisotope to prevent delays.</div></div><div><h3>RESULTS</h3><div>The 3D-HDR brachytherapy program was successfully implemented, with five cases treated in the first 2 months despite challenges such as high equipment costs, expertise and proficiency needs, and source replacement delays. Continuous training and quality assurance measures ensured the program's sustainability and effectiveness.</div></div><div><h3>CONCLUSIONS</h3><div>Implementing a 3D-HDR brachytherapy program in a system with restricted resources is possible with thorough planning, flexible strategies, and adaptive measures. We document our experience to provide insights for other institutions aiming to establish similar programs. Collaboration and innovative financial strategies are essential for ensuring sustainable access to cancer treatment in the region. Strategies such as remote training and proactive resource management, are critical for overcoming implementation barriers.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 2","pages":"Pages 258-264"},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901206","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}