Brachytherapy最新文献

{"title":"Instant plan quality prediction on transrectal ultrasound for high-dose-rate prostate brachytherapy","authors":"Tonghe Wang,&nbsp;Yining Feng,&nbsp;Joel Beaudry,&nbsp;David Aramburu Nunez,&nbsp;Daniel Gorovets,&nbsp;Marisa Kollmeier,&nbsp;Antonio L. Damato","doi":"10.1016/j.brachy.2024.10.009","DOIUrl":"10.1016/j.brachy.2024.10.009","url":null,"abstract":"<div><h3>PURPOSE</h3><div>We investigated the feasibility of AI to provide an instant feedback of the potential plan quality based on live needle placement, and before planning is initiated.</div></div><div><h3>MATERIALS AND METHODS</h3><div>We utilized YOLOv8 to perform automatic organ segmentation and needle detection on 2D transrectal ultrasound images. The segmentation and detection results for each patient were then fed into a plan quality prediction model based on ResNet101. Its outputs are values of selected dose volume metrics. Imaging and plan data from 504 prostate HDR boost patients (456 for training, 24 for validation, and 24 for testing) treated in our clinic were included in this study. The segmentation, needle detection, and prediction results were compared to the clinical results (ground truth).</div></div><div><h3>RESULTS</h3><div>For prediction model, the p-values of t-test between the predicted values and ground truth for either rectum D2cc or urethra D20% were larger than 0.8. The sensitivity of prediction model in finding implant geometries resulting in below-median rectum D2cc and urethra D20% were 83% and 87%.</div></div><div><h3>CONCLUSION</h3><div>The proposed method has great potential to facilitate the current prostate HDR brachytherapy workflows by providing valuable feedback during needle insertion, and facilitating decision making of where and if additional needles are required.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 171-176"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690082","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":"Complications of intravascular brachytherapy","authors":"Kent Wallner ,&nbsp;Kathleen E. Kearney ,&nbsp;Lorenzo Azzalini ,&nbsp;Edward Y. Kim ,&nbsp;Upendra Parvathaneni ,&nbsp;George Sandison ,&nbsp;William L. Lombardi ,&nbsp;Creighton Don ,&nbsp;Minsun Kim","doi":"10.1016/j.brachy.2024.11.006","DOIUrl":"10.1016/j.brachy.2024.11.006","url":null,"abstract":"<div><h3>INTRODUCTION</h3><div>There is some evidence of a dose-response relationship for intravascular brachytherapy (IVBT) of native vessel or first-time in-stent restenosis (ISR). It has also been shown that in-field failure predominates following intravascular brachytherapy-treated lesions. Accordingly, it may be advantageous to increase the radiation dose(s) currently used. Given the rationale for escalation from currently doses, a scrutiny of the potential complications that have been reported seems timely.</div></div><div><h3>METHODS</h3><div>PubMed was searched from 1966 through November 21st, 2023, using the terms <em>coronary and brachytherapy,</em> yielding 1287 references. A 10/16/24 follow-up search of Embase, using the terms “coronary and brachytherapy and complications”, yielding 511 articles. In total, 68 articles were identified as adverse event reports based on their title, or by scrutinizing articles that did not mention adverse events in their titles.</div></div><div><h3>RESULTS</h3><div>The best documented adverse IVBT-related event is the occurrence of late (&gt; 1 month) thrombosis. Following identification of the risk, longer DAPT regimens were adopted, bringing the incidence to non-IVBT levels. A variety of other adverse events have been reported, including aneurysms, dissections, arterial spasm, “black holes” and vasomotor response inhibition. However, none of which were associated with adverse clinical outcomes.</div></div><div><h3>CONCLUSIONS</h3><div>Nearly all reports regarding IVBT-related complications are retrospective analyses of a limited number of events, subject to reporting bias. Clinically important IVBT-related complications, at current doses, appear highly unlikely.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 103-109"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807175","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":"Improving plan quality in cervical cancer brachytherapy using knowledge-based planning for direction modulated brachytherapy tandem applicator","authors":"Suman Gautam ,&nbsp;Emily Flower ,&nbsp;Dylan Richeson ,&nbsp;Ikchit Sangha ,&nbsp;Tianjun Ma ,&nbsp;William Y. Song","doi":"10.1016/j.brachy.2024.11.001","DOIUrl":"10.1016/j.brachy.2024.11.001","url":null,"abstract":"<div><h3>PURPOSE</h3><div>The bladder and rectal toxicities in cervical cancer brachytherapy are positively correlated with the DVH parameter: D2cc. This study evaluates the feasibility of knowledge-based planning to predict the D2cc, identify suboptimal plans, and improve the plan quality with Direction Modulated Brachytherapy (DMBT) applicators using knowledge-based planning based on linear relationship between overlap distances and D2cc.</div></div><div><h3>METHODS</h3><div>The overlap volume histogram (OVH) method was used to determine the distances for 2 cm³ of overlap between the Organs at Risks (OAR) and High-Risk Clinical Target Volume (CTV_HR). Linear plots were utilized to model the OAR D2cc and 2 cm³ overlap distances. Two datasets from 45 patients (125 plans) were used to create 2 independent models: Model 1 from 59 Intracavitary (IC) and Model 2 from 66 Intracavitary-Interstitial (ICIS) plans. Performances were compared using 5-fold cross-validation. The predicted D2cc values were used as the maximum constraints in the inverse planning optimization.</div></div><div><h3>RESULTS</h3><div>The mean bladder D2cc decreased by 4.3% and 10.3% for conventional applicators, and 4.4% and 3.6% for DMBT applicators for Models 1 and 2, respectively. The rectum D2cc decreased by 3.4% and 10.7% for conventional and 3.0% and 5.0% for DMBT applicators, respectively. The sigmoid D2cc decreased by 3.1% and 6.9% for conventional and 3.2% and 5.9% for DMBT applicators, respectively. There were also significant reductions for the recto-vaginal (RV-RP) point and posterior-inferior border of symphysis (PIBS) reference points: PIBS+2cm, PIBS+1cm, PIBS-1cm, and PIBS-2cm, for both models as well.</div></div><div><h3>CONCLUSIONS</h3><div>A knowledge-based planning method successfully predicted D2cc and optimized brachytherapy plans for cervical cancer. The proposed model demonstrates the feasibility of predicting D2cc, detecting suboptimal plans, and improving the plan quality especially for DMBT where cumulative clinical experience is limited.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 144-153"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793051","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":"Ruthenium-106 (106Ru) plaque brachytherapy as salvage treatment for retinoblastoma following intravenous chemotherapy","authors":"Vijay Anand Reddy Palkonda ,&nbsp;Aiswarya Ramachandran ,&nbsp;Bolajoko Abidemi Adewara ,&nbsp;Ritesh Verma ,&nbsp;Vishal Raval ,&nbsp;Swathi Kaliki","doi":"10.1016/j.brachy.2024.06.008","DOIUrl":"10.1016/j.brachy.2024.06.008","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To describe the clinical presentation and treatment outcomes of patients undergoing Ruthenium-106 (¹⁰⁶Ru) plaque brachytherapy as salvage treatment for retinoblastoma (RB) following intravenous chemotherapy (IVC).</div></div><div><h3>METHODS</h3><div>Retrospective chart review of 44 eyes of 42 patients. The indications for plaque brachytherapy included solid tumor recurrence (n=20; 45%), solid tumor residual (n=16; 36%), new subretinal seeds (n=5; 12%), and new solid tumor (n=3; 7%).</div></div><div><h3>RESULTS</h3><div>The median age at the presentation was 12 months (range, 3–72 months). Based on ICRB classification, 8 (18%), 8 (18%), 16 (36%), and 5 (12%) tumors belonged to Groups B, C, D, and E, respectively. A median interval of 5 months (range 3–21 months) was noted between the last IVC cycle and plaque brachytherapy. The mean tumor height was four mm (range, 1.5–6 mm). All patients were treated with ¹⁰⁶Ru plaque (round or notch) with a median total dose of 45 Gy (range, 40–55 Gy) delivered to the tumor apex. At a mean post plaque follow-up period of 28 months (median, 23 months; range, 3–132 months), tumor completely regressed in 25 eyes (56%). Tumor recurrence within the plaque site was noted in eight eyes (18%) associated with a type 2 regression pattern (75%). At the last follow-up, the globe salvage rate was 24 eyes (55%), while 2 patients (5%) died due to metastasis.</div></div><div><h3>CONCLUSION</h3><div>¹⁰⁶RU plaque brachytherapy can be a useful salvage treatment for focal tumors (new or recurrent) following systemic IVC.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 76-85"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142696090","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":"Reconstruction errors in clinical intraoperative TRUS–based prostate HDR-BT detected using electromagnetic tracking","authors":"Ioannis Androulakis ,&nbsp;Jérémy Godart ,&nbsp;Lorne Luthart ,&nbsp;Miranda E.M.C. Christianen ,&nbsp;Henrike Westerveld ,&nbsp;Remi A. Nout ,&nbsp;Mischa Hoogeman ,&nbsp;Inger-Karine K. Kolkman-Deurloo","doi":"10.1016/j.brachy.2024.11.004","DOIUrl":"10.1016/j.brachy.2024.11.004","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To investigate the occurrence of errors in transrectal ultrasound (TRUS)-based implant reconstructions for high-dose-rate brachytherapy (HDR-BT) in prostate cancer using an afterloader-integrated electromagnetic tracking (EMT) system.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Fourteen patients were treated with one TRUS-based treatment fraction in an intraoperative setting while under general anesthesia, as part of their prostate HDR-BT (2×13.5 Gy) treatment. EMT measurements were performed before the start of the treatment in all implanted needles at dwell positions (DPs) with an interval of 5 mm. The Euclidean distances (EDs) between clinically reconstructed and EMT-measured DPs after registration were calculated. Errors were evaluated per needle (minimum ED of 2mm) and stratified into 4 severity levels (minor, moderate, major and severe). Error causes were investigated through retrospective inspection of TRUS imaging.</div></div><div><h3>RESULTS</h3><div>The median (range) ED between EMT-measured and clinically reconstructed DPs was 1.0 (0.1–9.4) mm. Higher EDs were observed in the anterior and lateral regions of the prostate. From 265 evaluated needle reconstructions, 23% (61/265) had minor errors or higher, while 9% (24/265) had major or severe errors. Severe errors were mostly caused by incorrect needle or depth selection. Major, moderate and minor errors were mostly caused by artifact, shadowing, and user errors, respectively.</div></div><div><h3>CONCLUSIONS</h3><div>This study found that a quarter of needle reconstructions contained errors &gt;2mm, and that high and severe errors were not uncommon. EMT can play an important role in detecting and preventing these reconstruction errors without disrupting the clinical workflow.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 177-185"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and dosimetric outcomes of a 3-fraction high-dose-rate brachytherapy boost for the treatment of locally advanced cervical cancer in a safety net hospital","authors":"Karen Cheng ,&nbsp;Samuel To ,&nbsp;Zichen Liu ,&nbsp;Hye Ri Han ,&nbsp;Derrick Lock ,&nbsp;Priya Mitra ,&nbsp;Omar Ragab ,&nbsp;Andrew Lim ,&nbsp;Fahad Momin ,&nbsp;Shelly Bian","doi":"10.1016/j.brachy.2024.11.003","DOIUrl":"10.1016/j.brachy.2024.11.003","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To report outcomes of a 3-fraction HDR brachytherapy boost for the treatment of locally advanced cervical cancer (LACC) at a large safety net hospital.</div></div><div><h3>METHODS AND MATERIALS</h3><div>A retrospective review of 93 patients with FIGO 2018 Stage IA2 to IVB cervical cancer treated with HDR brachytherapy boost in 3 fractions between 2017 and 2022 was conducted. The 2-year local control (LC), progression-free survival (PFS), and overall survival (OS) was estimated using Kaplan-Meier estimators. Hazard ratios of covariates for local failure (LF) were determined using univariate Cox proportional hazard models.</div></div><div><h3>RESULTS</h3><div>Median follow-up time was 31 months. Mean cumulative EQD2 of HR-CTV D90 was 85.3 Gy (95% CI 84.2, 86.4). Mean cumulative EQD2 of the D2cc for bladder, rectum, sigmoid, and small bowel was 74.7 Gy (95% CI 72.4, 77.0), 58.2 Gy (95% CI 56.7, 59.6), 60.9 Gy (95% CI 59.4, 62.3), and 58.9 Gy (95% CI 56.7, 61.1) respectively. Two-year LC, PFS, and OS were 80.9% (95% CI 73.1%, 89.5%), 63.2% (95% CI 54.0%, 74.1%), and 85.2% (95% CI 78.1%, 93.0%) respectively. The hazard ratio for LF for incomplete concurrent chemotherapy regimen was 3.07 (95% CI 1.17, 8.09; <em>p</em> = 0.02). Three percent of patients experienced late grade 3+ toxicities after radiation therapy.</div></div><div><h3>CONCLUSIONS</h3><div>Three-fraction HDR brachytherapy boost was generally well-tolerated by patients and may be a viable alternative in the treatment of LACC.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 162-170"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793036","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 effect of one-room CT guided brachytherapy on procedure time and cost in the treatment of cervical cancer","authors":"Evelien B. van Well ,&nbsp;Timothy N. Showalter ,&nbsp;Stavroula Giannouli ,&nbsp;Elena Nioutsikou ,&nbsp;Maroeska M. Rovers ,&nbsp;Tim M. Govers","doi":"10.1016/j.brachy.2024.08.254","DOIUrl":"10.1016/j.brachy.2024.08.254","url":null,"abstract":"<div><h3>Purpose</h3><div>Brachytherapy is associated with improved overall survival in cervical cancer patients, but the utilization seems hindered by high costs and relatively low reimbursement, particularly in the US. A one-room brachytherapy suite with CT (ORBT) could optimize the treatment workflow. By eliminating transport and waiting times, limiting applicator movement, and providing real-time applicator placement feedback, treatment time and costs could potentially be reduced. This study assesses the potential value of implementing ORBT in cervical cancer treatment.</div></div><div><h3>Methods and Materials</h3><div>A variable cost model was developed to compare current (multi-room) brachytherapy workflows (MBRT) to ORBT, taking into account staff utilization, staff, equipment and consumables costs and room expenses. Two current care scenarios were simulated; applicator placement performed in the operating room (S1), and applicator placement performed in a brachytherapy suite (S2). For both scenarios literature reported fraction times of MBRT were compared to a range of ORBT times. Sensitivity analyses were performed to determine the influence of input parameters.</div></div><div><h3>Results</h3><div>In scenario one, the results showed yearly savings of $45,572 up to $339,439 (USD), assuming a 5% and 20% reduction in fraction duration, respectively, in ORBT compared to MRBT. In scenario two, ORBT does not result in costs savings at 5% to 15% improvement. Therefore, only when ORBT results in a &gt;20% improvement of fraction time, cost will be saved.</div></div><div><h3>Conclusions</h3><div>The results indicate that reducing procedure time (using ORBT) can lead to cost savings, depending on the current workflow. Savings seem to depend mostly on applicator placement location, number of patients per year, and involved personnel.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 30-35"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of abbreviated high dose-rate brachytherapy in locally advanced cervical cancer: lessons from the COVID pandemic for high dose-rate fractionation","authors":"Supriya Chopra ,&nbsp;Asesh Samanta ,&nbsp;Arunima Nagar ,&nbsp;Prachi Mittal ,&nbsp;Ankita Gupta ,&nbsp;Jaahid Mulani ,&nbsp;Jeevanshu Jain ,&nbsp;Satish Kohle ,&nbsp;Yogesh Ghadi ,&nbsp;Sushmita Rath ,&nbsp;Seema Gulia ,&nbsp;Jaya Ghosh ,&nbsp;Sudeep Gupta","doi":"10.1016/j.brachy.2024.10.010","DOIUrl":"10.1016/j.brachy.2024.10.010","url":null,"abstract":"<div><h3>PURPOSE</h3><div>To evaluate outcomes of cervical cancer patients treated with abbreviated high dose rate brachytherapy (HDR-BT) that used 2-implants and delivered 4–5 fractions over 7–12 days rather than 21–28 days.</div></div><div><h3>MATERIALS AND METHODS</h3><div>Patients with stage IB2–IVA cervical cancer, treated with external beam radiation (EBRT) <span><math><mo>±</mo></math></span> chemotherapy followed by abbreviated MR/CT-based HDR-BT were included. The planning aim was to achieve &gt; 70Gy equivalent doses in 2Gy (EQD2_10Gy) at Point A dose in patients undergoing intracavitary BT (ICBT) and &gt; 85Gy EQD2_10Gy to the HRCTV in intracavitary-interstitial BT (IC-ISBT). The dose constraints to 2 cc of bladder, rectum and sigmoid were restricted to &lt; 90Gy₃, &lt; 75Gy₃ and &lt; 75Gy EQD2_3Gy respectively.</div></div><div><h3>RESULTS</h3><div>From 2020 to 2022, 245 patients were treated with EBRT followed by MR/CT-based HDR-BT. Median OTT was 57 days. The median HRCTV volume was 35.5cc with higher HRCTV in MR than CT-based (42.3cc vs. 32.8cc). The median dose to Point-A, HRCTV-D90, B2cc, R2cc and S2cc for ICBT was 78.1, 86.2, 87, 70.2 and 70.4Gy respectively. For IC-ISBT cohort, the median dose to HRCTV-D90, B2cc, R2cc, and S2cc was 86.1, 88.6, 70 &amp; 66.7Gy respectively. The 3-years local control, pelvic control, locoregional, disease free and overall survival was 90%, 88%, 83.7%, 75.5% and 85% respectively. Late ≥ grade III gastrointestinal and genitourinary toxicities were 7.3% and 1.6% respectively with marginally higher toxicity in CT based cohort.</div></div><div><h3>CONCLUSION</h3><div>Accelerated HDR-BT schedule of 2-implants 4–5 fractions is radiobiological iso-effective and clinically safe with comparable oncological outcomes and adverse events.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 1-10"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142793040","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":"Anticoagulation management in gynecologic brachytherapy patients with perioperative or chronic thromboembolic disease: A retrospective analysis","authors":"Osagie Igiebor ,&nbsp;Samuel Lewis Cooper ,&nbsp;Brian Orr ,&nbsp;Harriet Eldredge-Hindy","doi":"10.1016/j.brachy.2024.10.006","DOIUrl":"10.1016/j.brachy.2024.10.006","url":null,"abstract":"<div><h3>PURPOSE</h3><div>Women on chronic anticoagulation (AC) who require operative brachytherapy for gynecologic malignancies represent a clinical challenge, but no guidelines exist regarding patient selection for brachytherapy or their perioperative management. We aimed to understand the incidence of hemorrhagic and embolic events in our patients on chronic AC and suggest management strategies for this patient population.</div></div><div><h3>MATERIALS AND METHODS</h3><div>A retrospective, single institutional study of patients treated with operative, gynecologic brachytherapy from 2013 to 2023 was performed to identify patients on chronic AC. We determined indications for AC use, oncologic therapy characteristics, duration of AC interruption, and therapy outcomes. The primary aim was to determine perioperative embolic or hemorrhagic complications as measured by the Common Terminology Criteria for Adverse Events.</div></div><div><h3>Results</h3><div>Of 304 patients treated with operative implants, 32 (10%) were on chronic AC for venous thromboembolism (n = 25), or atrial fibrillation/flutter (n = 13). The most common malignancies were cervical (n = 15) and inoperable uterine (n = 11). Implants were intracavitary (n = 14), interstitial (n = 6), or hybrid (n = 12) with a median (range) of 2 (1-3) implants, 4 (2-5) fractions, and 2 (1-3) days of bedrest per implant. 63% (n = 20) had an epidural for analgesia. AC was held for a median 3 days in 94% (n = 30) prior to the operative implant, and pharmacologic DVT prophylaxis was used in 78% (n = 25). There were two grade ≥ 2 hemorrhagic events and no new embolic events.</div></div><div><h3>Conclusions</h3><div>The rate of bleeding and embolic events was acceptable, and women on chronic AC should not be excluded from potentially lifesaving operative brachytherapy, including complex cases that require spinal analgesia and interstitial applicators.</div></div>","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Pages 154-161"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634374","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":"“Erratum to keeping your best options open with AI-based treatment planning in prostate and cervix brachytherapy” [Brachytherapy Volume 23, ISSUE 2, P188-198, March 2024]","authors":"Leah R.M. Dickhoff ,&nbsp;Renzo J. Scholman ,&nbsp;Danique L.J. Barten ,&nbsp;Ellen M. Kerkhof ,&nbsp;Jelmen J. Roorda ,&nbsp;Anton Bouter ,&nbsp;Laura A. Velema ,&nbsp;Lukas J.A. Stalpers ,&nbsp;Bradley R. Pieters ,&nbsp;Peter A.N. Bosman ,&nbsp;Tanja Alderliesten","doi":"10.1016/j.brachy.2024.11.009","DOIUrl":"10.1016/j.brachy.2024.11.009","url":null,"abstract":"","PeriodicalId":55334,"journal":{"name":"Brachytherapy","volume":"24 1","pages":"Page 197"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017671","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}