Brachytherapy最新文献

{"title":"PO65","authors":"Eulanca Yuka Liu, Eric Lin, Puja Venkat, Alan Lee, Jay Shiao, Andrew Wong, Austin Yu, Mary Ann Hagio, Sang-June Park, D. Jeffrey Demanes, Albert J. Chang","doi":"10.1016/j.brachy.2023.06.166","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.166","url":null,"abstract":"Purpose This retrospective study compares high dose rate brachytherapy (HDR BT) monotherapy against HDR BT and external beam radiation therapy (EBRT), with and without androgen deprivation therapy (ADT), to determine non-inferiority of HDR BT alone in the treatment of unfavorable intermediate risk (UIR) prostate cancer. Materials/Methods Data were obtained from two registries from 1991-present. 633 patients with UIR prostate cancer treated with HDR BT were included. Patients who received only HDR BT received 42-45Gy/6 fractions (fx) or 27 Gy/2 fx. For HDR BT+EBRT, the HDR dose was 20-24 Gy/2 fx, 24 Gy/4 fx, or 15 Gy/1 fx. EBRT patients received 45 Gy/25 fx to the prostate +/- pelvic nodal radiation. GU/GI toxicities were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Treatment group differences were assessed via two-sample T test or ANOVA, and associations between categorical variable and treatment group were assessed via chi-squared or Fisher's exact test. Time-to-event analyses were carried out to evaluate relationship between treatments and primary outcome variables. Five primary endpoints were used to assess freedom from biochemical recurrence (FFBC), freedom from distant metastasis (FFDM), freedom from local failure (FFLF), cancer specific survival (CSS), and overall survival (OS). Univariate analysis was conducted using the Kaplan-Meier method and log-rank test to the primary event. For multivariate analysis, Cox proportional hazard (Cox PH) regression and Fine & Gray competing risk regression were carried out to adjust for potential confounders. For toxicity analysis, the association between the incidence of post-treatment severe GU/GI toxicity reaction, denoted grade 3 or higher, and the treatment group was evaluated via chi-squared or Fisher's exact test. Results Statistical comparisons for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT are summarized in Table 1. From the Kaplan-Meier curves and log-rank tests, no differences between the three cohorts were identified in all five survival outcomes (FFBC, FFDM, FFLF, OS, CSS), with 5-year survival for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT FFBC 99%, 95%, and 94% respectively. Multivariate analysis with Cox PH regression showed no differences in FFBC, FFDM, OS, and CSS with addition of EBT alone, or addition of EBT with ADT. Fine and Gray competing regression showed no difference in outcome for HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT with respect to FFBC, FFDM, and CSS. Performing the likelihood ratio test to both the Cox PH and Fine & Gray competing regression models resulted in no differences in all survival outcomes with stable fits between treatment and non-treatment groups. In comparing CTCAE toxicities between the HDR, HDR+EBRT-ADT, and HDR+EBRT+ADT cohorts, no statistically significant differences were identified in GI and GU toxicities when comparing post-treatment and baseline toxicities. No Grade 2 or 3 GI toxicities were identified in any of the groups, while ","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO112","authors":"Juan Wang, Xiaolu Pei","doi":"10.1016/j.brachy.2023.06.213","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.213","url":null,"abstract":"Purpose A meta-analysis aimed to systematically evaluate the safety and efficiency of iodine-125 (125I) irradiation stent placement for patients with malignant biliary obstruction (MBO) Methods Embase, Medline, PubMed, Cochrane library, and OVID were systematically searched from the earliest to November 2021. The primary endpoints were stent patency and overall survival. The secondary endpoints were total bilirubin (TB) and alanine aminotransferase (ALT) level and complications. Two independent researchers strictly screened the documents, extracted the valuable data, and evaluated the quality of documents. Meta-analysis was performed using Stata 12.0 and RevMan 5.4 software. Results 950 patients were included in nine studies, 415 of them received 125I seed implantation and 535 were in the mental stents group. Meta analysis showed that the stent patency rate in the experimental group improved in 3 months (OR=5.19, 95%CI=2.74-9.8,P<0.01), and that in MBO patients also significantly increased in 6 months (OR=4.46, 95%CI=2.87-6.93, P<0.01). Meanwhile, the postoperative 6-month survival rate was significantly improved (OR=1.63, 95%CI=1.13-2.35, P=0.009).It also reduced patient's mortality risk (HR=0.67, 95%CI=0.5-0.86, P=0.002). Subgroup analysis found that different doses may lead to different patency rates. However, the postoperative 12-month survival rate was not improved. (OR=1.42, 95%CI=0.27-2.6, P=0.25). There was no significant difference in the occurrence of adverse events between the two groups (OR=1.24, 95%CI=0.69-2.21. P=0.47). Conclusions For patients with unresectable malignant biliary obstruction (MBO), placement of an irradiation stent has been demonstrated to offer longer patency and survival compared with the control group. Our aim was to further assess the efficacy of irradiation stents. A meta-analysis aimed to systematically evaluate the safety and efficiency of iodine-125 (125I) irradiation stent placement for patients with malignant biliary obstruction (MBO) Embase, Medline, PubMed, Cochrane library, and OVID were systematically searched from the earliest to November 2021. The primary endpoints were stent patency and overall survival. The secondary endpoints were total bilirubin (TB) and alanine aminotransferase (ALT) level and complications. Two independent researchers strictly screened the documents, extracted the valuable data, and evaluated the quality of documents. Meta-analysis was performed using Stata 12.0 and RevMan 5.4 software. 950 patients were included in nine studies, 415 of them received 125I seed implantation and 535 were in the mental stents group. Meta analysis showed that the stent patency rate in the experimental group improved in 3 months (OR=5.19, 95%CI=2.74-9.8,P<0.01), and that in MBO patients also significantly increased in 6 months (OR=4.46, 95%CI=2.87-6.93, P<0.01). Meanwhile, the postoperative 6-month survival rate was significantly improved (OR=1.63, 95%CI=1.13-2.35, P=0.009).It also reduced patient's","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"135 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO94","authors":"Derek Liu, Nawaid Usmani, Nick Chng, Ron Sloboda","doi":"10.1016/j.brachy.2023.06.195","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.195","url":null,"abstract":"Purpose Prostatic edema following transperineal interstitial permanent prostate brachytherapy implantation is commonly evaluated based on either prostate or implant volume. The current study compares the edema time course between the MR-delineated prostate contour and the CT-localized stranded seeds, enabling pairwise comparison in the presence of individual patient variation. In addition, unique identification of seeds enables the characterization of stranded implant dynamics. Materials and Methods Twenty patients were implanted with stranded Iodine-125 seeds (0.5 U strength) to the prostate at a prescribed dose of 145 Gy, following standard procedure. Pelvic scans were performed using computer tomography (CT) and magnetic resonance imaging (MRI) (T2-weighted fast spin-echo and balanced steady-state free precession (bSSFP)) on the day of implantation (D0), D3, D10, and D30 (30 days post-implant). A Prostate Coordinate System, based on the MR-delineated prostate contour, served as a common coordinate system across all time points. MR(bSSFP)-CT rigid registration was performed based on the mutual information metric. A strand reconstruction software uniquely matched individual seeds to the strand configuration in the preplan. The relative edema, normalized to D30, was calculated for MR-based contours and CT-based seed positions. Correlated movement of seeds within a strand were quantified: strand movement was calculated from the shift in the strand center-of-mass; strand length was determined as the total length of the line segments connecting sequential seeds in a strand. Simulation of the stranded seed model was performed. Initial D0 seed positions were moved based on the observed strand characteristic movement and compared against actual D30 seed positions. Results Prostatic edema resulted in swelling of the prostate, which peaks at D0 and mostly resolves by D30. The contour- and seed- based relative edema were similar and correlated (p < 0.01) in the lateral and ant-pos directions. The edema magnitudes differed noticeably in the sup-inf direction with no statistically significant correlation (p = 0.11). The average strand movement was 0.09, 0.12, and 0.26 cm in the Lateral, Ant-Pos, and Sup-Inf directions respective, resulting in a more compact seed distribution. The movement was largest between D0 and D3 and smallest between D10 and D30. Conversely, the strand length was relatively constant during the initial time points, followed by a length contraction of 5% between D10 and D30. Thus, the stranding material initially limits independent seed movement (i.e. strands moved as a whole) and subsequently loses integrity over time, allowing for strand contraction. Simulation of the stranded seed model reproduced the observed relative edema, particularly in the Sup-Inf strand direction. The average residual distance between simulated and actual D30 seed positions was 0.27 cm. For comparison, the actual seed movement was 0.38 cm and the residual from ","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"69 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO120","authors":"Sang June Park, Serhii Brovchuk, Zoia Shepil, Oleg Vaskevych, Puja Venkat","doi":"10.1016/j.brachy.2023.06.221","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.221","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO87","authors":"Danilo Maziero, Catheryn Yashar, Jyoti Mayadev, Dominique Rash, Daniel Scanderbeg","doi":"10.1016/j.brachy.2023.06.188","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.188","url":null,"abstract":"Purpose To propose a generalization of the known relationship between total reference air Kerma (TRAK) and isodose surface volumes for intracavitary, hybrid and interstitial applicators used for treating cervical cancer with high dose rate (HDR) brachytherapy (BT). Materials and Methods A single institution cohort of 123 retrospective clinical HDR BT plans from 34 patients treated for cervical cancer were evaluated. The cohort consisted of 71 intracavitary (tandem and ring - T&R - and tandem and ovoid - T&O), 32 hybrid (T&R or T&O with the addition of stainless steel and/or flexi needles) and 20 interstitial plans. Patients received 45Gy external beam radiotherapy (EBRT), followed by one of three fractionation schemes delivered with BT: 600cGy x 4 fractions (4 patients for a total of 16 fractions), 700cGy x 4 fractions (21 patients for a total of 80 fractions) and 800cGy x 3 fractions (9 patients for a total of 27 fractions). The average dose per fraction was 708.9±58.5cGy considering all 123 plans. For each plan the isodose surface volumes (TPSvol) were evaluated considering the accumulated EBRT and BT dose. Because three different fractionation schemes were used, the radiobiological equivalent doses in 2Gy fractions (EQD2) were estimated considering the EBRT and BT contributions. We have considered α/β ratio = 10Gy for tumor repair and repair half time T1/2 = 1.5 hour. In this work we have considered three reference dose levels (dref): 60Gy, 75Gy and 85Gy. Figure 1A-C illustrates the isodose surface volumes for the different fractionation schemes. The TRAK of each plan was also recorded. The relationship between TRAK/dref and TPSvol for the different applicators was evaluated by applying a second degree polynomial linear regression considering the two variables for each case. Results The linear regressions showed correlation coefficients R2 of 0.998, 0.997, 0.995 and 0.997 for the data obtained from treatments using intracavitary (Fig. 1D), hybrid (Fig. 1E), interstitials (Fig. 1F) and all applicators together (Fig. 1G), respectively. The linear regressions were not found to be affected by the different fractionation schemes. The quadratic, linear coefficients and the curve intercepts ranged from 0.621 to 0.739, 11.29 to 12.64 and -16.9 to -12.32, respectively. The fitted equation for the hybrid implants (Fig. 1E) showed the largest differences for the quadratic coefficient and curve intercept when compared to the equation fitted for intracavitary and interstitial applicators. The equation resulting from all applicators (Fig. 1G) showed the smallest differences for quadratic and linear coefficients when compared to the equation resulting intracavitary applicators. Conclusions We have shown that TRAK might be useful to predict volumes of isodose surfaces independently of the applicator and fractionation scheme used for treating cervical cancer with BT. The potential to use the correlation between TRAK and volumes of isodose surfaces to predict p","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO48","authors":"Rustica Cerillo, Amber Malloy, Mary Ann Monson, Lisa Thigpen, Kimberly DeBaun","doi":"10.1016/j.brachy.2023.06.149","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.149","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO46","authors":"Hayden Anthony Ansinelli, Arjit Baghwala, Chengfeng (Brandon) Li, Ramiro Pino, E. Brian Butler, Bin S. Teh, Andrew M. Farach","doi":"10.1016/j.brachy.2023.06.147","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.147","url":null,"abstract":"","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO116","authors":"Mustafa M. Basree, Charles Wallace, Jessica Schuster, Jessica Miller, Michael Lawless, Juliet L. Aylward, Yaohui Xu, Kristin Bradley, Randall J. Kimple, Adam Burr","doi":"10.1016/j.brachy.2023.06.217","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.217","url":null,"abstract":"Purpose Non-melanoma skin cancer is the most common cancer worldwide and its treatment in the elderly can pose significant challenges. We established a skin brachytherapy program primarily to treat older patients using the hypofractionated courses and superficial treatment depth afforded by this technique. Here we describe the first patients treated at our institution, including our initial oncologic results and toxicities. Materials and Methods This is a single-institution retrospective review of non-melanoma skin cancer patients treated at our institution from March 2020 to October 2022 with high dose rate brachytherapy with iridium-192. Either the 2 or 3 cm Valencia applicator was used to treat 25 of 27 lesions with a prescription depth of 3 mm. The Valencia was fixed in place using a clamp and patients were immobilized using a custom head sponge. The other two lesions were treated using a custom array of catheters in Aquaplast and a Freiburg flap. Baseline characteristics and treatment-related variables were summarized using descriptive statistics. Acute and late radiation toxicities were graded using RTOG Common Toxicity Criteria. Local control was evaluated using the Kaplan Meier method. Results Twenty-one patients were identified (n=11 F; n=10 M), with twenty-seven lesions. Median age 81 years (range, 55 to 104), with 85.2% basal- and 14.8% squamous-cell carcinoma. Median follow up was 10.1 months (1.0 to 31.8). Treated lesions were located on the face (n=14), head (n=6), lower extremity (n=5), and neck (n=2), with median lesion size of 8 millimeters (2.5 to 30). Patients were treated with median 40 Gy (40 to 48.5) in 8 fractions (5 to 16) prescribed to depth of 3 mm (3 to 5). RTOG grade 1 skin toxicity (mild erythema) was present in 17 lesions and grade 2 toxicity (brisk erythema) was present in 10 lesions. The most common late toxicity was hypopigmentation in 3 patients. One patient developed a late grade 3 ulcer in a poorly perfused lower limb. Local control was 95.7% on a per lesion basis at one year with a marginal failure in 1/27 lesions. Conclusions Our initial experience with non-melanoma skin brachytherapy has shown good local control with an acceptable safety profile in a predominantly elderly population. Treatment of non-melanoma skin cancers on the lower extremity in elderly patients remains an ongoing challenge due to the risk of late toxicity. Further studies are needed to compare the acute and late toxicity of surface brachytherapy to widely available external beam techniques such as electron beam radiation therapy. Currently, the excellent local control and short treatment courses provide a great treatment option for superficial, early stage non-melanoma skin cancers. Non-melanoma skin cancer is the most common cancer worldwide and its treatment in the elderly can pose significant challenges. We established a skin brachytherapy program primarily to treat older patients using the hypofractionated courses and superficial trea","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO103","authors":"Thomas Harris, Ivan M. Buzurovic, Evangelia Kaza, Desmond A. O'Farrell, Christian V. Guthier, Robert A. Cormack, Davide Brivio, Michael Lavelle, Phillip M. Devlin","doi":"10.1016/j.brachy.2023.06.204","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.204","url":null,"abstract":"Purpose Dupuytren's contracture (DC) is an inflammatory disorder of the palm resulting in fascia thickening into nodules and cords. Although typically not painful, the cords can cause increased fixed flexion of one or more fingers (usually the 4th or 5th digits) to remain bent towards the palm. Prospective clinical trials have shown radiation's ability to stabilize or even improve symptoms in the majority of cases. Brachytherapy can be used to target the affected region while providing a rapid dose falloff to spare healthy tissue, and can also easily modulate treatment depth within the field. In some MRI sequences the cords yield a characteristic signal. This study examines if MR imaging in combination with surface applicator brachytherapy (SABT) may allow accurate targeting of the fibrosed region. Materials and Methods Five patients with DC, one with bilateral disease, underwent MR-guided surface applicator brachytherapy in our clinic. For each of the six hands, a CT simulation was performed followed immediately by MR scans. At simulation, the hand was palpated to locate the nodules and cords to be treated; up to a 2 cm margin was then applied and marked with a non-ferrous CT wire. A flap applicator was laid on top of the treatment region and secured with Coban wrap. A CT scan was acquired with the patient's hand stretched out over the head in swimmer's position, if tolerable. After CT and before unwrapping the applicator, the patient underwent MRI with a T1-weighted DIXON VIBE sequence, while in the same positioning. At treatment planning the catheters were reconstructed on the CT scan, which was then fused to the T1 DIXON VIBE in-phase scan for target evaluation. Treatment extent marked by CT wire was compared to MRI, and treatment depth was determined by the MRI findings. Patients received daily 3 Gy x 10 fxs, with a 6-8 week break following fraction 5, a common dose regime used in published literature. Results All six courses of radiation were well tolerated with no acute grade I toxicities. MRI target regions were all contained within the 2 cm margin marked at simulation. For CT-only treatment planning, our clinic prescribes to a uniform depth of 3 mm; however, the MRI showed localized increased depth of fibrosis up to a maximum of 8.5 mm, which was accounted for during treatment planning. The in-phase DIXON images were selected for treatment planning to avoid the phase cancellation artifact present at fat-water interfaces on the opposed-phase DIXON images, which nevertheless demonstrated higher flap applicator visibility. The possibility of MR-only SABT by combining different MR sequences and contrasts is being separately investigated. One patient was unable to accommodate the swimmer's position during simulation, and had his hand placed on his abdomen. That patient's MR was partially affected by motion artifacts but was still useful in target delineation. Conclusions MR-guided SABT for DC is feasible and well tolerated. MR information was","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PO105","authors":"Irina Vasilievna Horot","doi":"10.1016/j.brachy.2023.06.206","DOIUrl":"https://doi.org/10.1016/j.brachy.2023.06.206","url":null,"abstract":"There are few approaches in treatment of non-melanoma skin cancer: operation, external irradiation, brachytherapy, use of appropriate medications. In brachytherapy it is possible to use rigid needles, flexible applicators and application methods. As a rule the choice depends on many factors - size of the tumor, location, histology, previous treatments etc. Purpose The aim of the work was to evaluate the effectiveness of applicator method in brachytherapy of non melanoma skin cancer. In this report we evaluate the results of the application method in treatment of non melanoma skin cancer. Patients and Methods 86 patients have been treated since 2017 till 2020 years. Basalioma was diagnosed in 59 pts, squamous cell carcinoma - in 27 pts. 47 pts had tumor in head and neck region, 21 - in different sites of the body and 18 - in limbs. 9 pts had recurrence after operation. The location of the applicators was chosen individually, they were attached to an individual mask that repeats the curves of the body and provides a rigid fixation of the applicators during treatment. Total dose amounted to 36 Gy (6 Gy * 6 fraction, 1 fraction per day) . The dose planning was performed at Oncentra 4.0. Treatment was fulfilled at Microselectron (30 channels) HDR. Planning was done on the basis of CT images. Dose normalisation depended on many factors and ranged from 3 mm till 10 mm if there was a necessity. As a rule, reaction to irradiation began at different times after the start of treatment but the peak of reactions usually happens in approximately 10 days after treatment completion and were strongly dealt with the tumor location. Results The healing lasted for three months on average. As a result in 83 patients (97%) the treatment effect was good: full tumor regression with good cosmetic effect. In 3 patients prolongacion morbi was observed and tumor was reirradiated. During the first year patients were under control every 3 months and later - every 6 months. Conclusion With the correct choice of application method, the results of the treatment of non-melanoma cancer can be considered as good. There are few approaches in treatment of non-melanoma skin cancer: operation, external irradiation, brachytherapy, use of appropriate medications. In brachytherapy it is possible to use rigid needles, flexible applicators and application methods. As a rule the choice depends on many factors - size of the tumor, location, histology, previous treatments etc. The aim of the work was to evaluate the effectiveness of applicator method in brachytherapy of non melanoma skin cancer. In this report we evaluate the results of the application method in treatment of non melanoma skin cancer. 86 patients have been treated since 2017 till 2020 years. Basalioma was diagnosed in 59 pts, squamous cell carcinoma - in 27 pts. 47 pts had tumor in head and neck region, 21 - in different sites of the body and 18 - in limbs. 9 pts had recurrence after operation. The location of the applicators w","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":"106 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135434371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}