Brachytherapy最新文献

{"title":"Impact of MRI-based planning in transperineal interstitial brachytherapy for locally advanced cervix tumors: Clinical, dosimetric and toxicity outcomes.","authors":"Diana Guevara Barrera, Silvia Rodríguez Villalba, Luis Suso-Martí, Enrique Sanchis-Sánchez, Jose Perez-Calatayud, Jose Domingo Lago Martín, Francisco Blázquez Molina, Manuel Santos Ortega","doi":"10.1016/j.brachy.2024.10.005","DOIUrl":"10.1016/j.brachy.2024.10.005","url":null,"abstract":"<p><strong>Purpose: </strong>To compare dosimetric characteristics, clinical outcomes, and toxicity in patients with locally advanced cervical cancer(LACC) treated with transperineal interstitial brachytherapy(P-ISBT), using CT-based planning or MRI-based planning with a monoinstitutional MRI-compatible applicator, Template Benidorm(TB).</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 106 women treated with P-ISBT for LACC from 2006 to 2022. P-ISBT was CT-based, with Martinez Universal Perineal Interstitial Template(MUPIT) between 2006 and 2012, or MRI-based planning (TB) since 2013. Volumetric, clinical, and dosimetric parameters were compared between applicators.</p><p><strong>Results: </strong>Forty-six (43.4%) patients were treated with MUPIT, and 60 (56.6%) with TB. Median follow-up was 42 months (4-188). No significant difference was observed in 5-year local control (LC), regional control (RC), distant failure (DF), overall survival (OS), and disease-specific survival (DSS) between applicators. The TB cohort had fewer needles (p = 0.001), halved median CTV volume (p < 0.001), increased median D_90%CTV dose (p < 0.005), and lower D_2cc values in rectum/bladder (p < 0.001). G3 chronic toxicity was 15% in the MUPIT group and 6% in TB (p = 0.15), with no G4 toxicity reported. Rectal hemorrhage was lower in the TB group (p = 0.002). Larger CTV volumes correlated with higher rectal D2cc and rectal hemorrhage (p = 0.001; p = 0.029, respectively), and enterovaginal fistula (p = 0.03; p < 0.001, respectively). Median CTV volume was 152.82 cc (35.3-256.78) in patients with chronic rectal toxicity and 102.9 cc (21.4-329.41) in those without (p = 0.001).</p><p><strong>Conclusion: </strong>MRI's superior CTV-volume definition results in smaller treatment volumes, lower D_2cc for rectum and bladder, and a trend towards higher CTV D_90%. Rectal hemorrhage was significantly lower in the MRI-based group. A significant correlation was observed between larger CTV-volumes, higher rectal D_2cc and rectal hemorrhage/enterovaginal fistula.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"134-143"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142647791","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":"Feasibility of balloon rectal spacer implantation in HDR and LDR brachytherapy for prostate cancer treatment.","authors":"Tomer Charas, Salem Billan","doi":"10.1016/j.brachy.2024.10.003","DOIUrl":"10.1016/j.brachy.2024.10.003","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the use of a biodegradable balloon rectal spacer in two prostate cancer patients undergoing low dose radiation (LDR) and salvage high dose radiation (HDR) brachytherapy. The spacer aims to reduce radiation dose to adjacent organs, particularly the rectum, in patients previously treated with radiation.</p><p><strong>Methods: </strong>The balloon spacer was implanted transperineally under transrectal ultrasonography (TRUS) guidance in two patients. For the LDR case (73-year-old, intermediate-risk), the balloon was placed postimplant with 55 iodine-125 seeds delivering 145 Gy. For the HDR case (66-year-old, high-risk), the balloon was placed one week before treatment, which delivered 23 Gy in two weekly fractions using 16 channels.</p><p><strong>Results: </strong>The balloon provided a 14-15mm separation between rectum and prostate. In the LDR case, prostate D90 was 149.1Gy (102.83%), V100 was 91.95%, and rectum D30 was 23.93Gy (16.50%). For the HDR case, prostate D90 was 11.63Gy (105.79%), V100 was 93.63%, and rectum D0.5cc was 8.04Gy (73.15%). Both patients tolerated the treatment well, with no observed postoperative complications at 6-month follow-up.</p><p><strong>Conclusions: </strong>The use of a rectal balloon spacer in both salvage HDR and LDR brachytherapy is feasible and safe, allowing for controlled placement and providing rectal protection from high radiation doses.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"186-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634396","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":"Image guided cervical brachytherapy practice patterns: 2023/2024 survey of the American brachytherapy society.","authors":"Elizabeth A Kidd, Santino S Butler, Ulysses Gardner, Akila N Viswanathan","doi":"10.1016/j.brachy.2024.10.013","DOIUrl":"10.1016/j.brachy.2024.10.013","url":null,"abstract":"<p><strong>Background: </strong>An update of the 2007 and 2014 surveys of the American Brachytherapy Society (ABS) will elucidate current practice patterns of cervical cancer brachytherapy.</p><p><strong>Methods: </strong>A 40-question survey was sent to all ABS members in June-July 2023 and February 2024; 167 responses were received, with 140 used for analysis. Results were compared to the 2014 survey using chi-squared testing. Multivariable logistic regression was used to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI) for outcomes of interest.</p><p><strong>Results: </strong>Compared to 2014, MRI use for treatment planning of the first brachytherapy fraction increased from 34% to 63% (p < 0.001), prescription to the high-risk clinical target volume (HR-CTV) increased from 52% to 94% (p < 0.001), while Point A prescription decreased from 42% to 16% (p < 0.001). Additionally, procedural guidance with ultrasound significantly increased (79% vs. 32%, p < 0.001) along with the use of interstitial needles (always or nearly always, >80%) (29% vs. 4%, p < 0.001). MRI availability around the time of procedure was the largest challenge to incorporating MRI into brachytherapy treatment planning. Compared to those with MRI access reserved specifically for Radiation Oncology, respondents with shared-access or out-of-department MRI were less likely to obtain treatment planning MRIs for each brachytherapy fraction (22% vs. 75%; aOR 0.10 [95% CI, 0.03-0.30], p < 0.001).</p><p><strong>Conclusion: </strong>For cervix cancer brachytherapy there has been significant increase in the use of MRI-based volumetric brachytherapy treatment planning, ultrasound guidance during procedures and the addition of interstitial needles. These advancements in practice patterns are congruent with published consensus guidelines and ongoing training initiatives. However, MRI access and lack of easy availability continue to be significant challenges for optimizing cervix brachytherapy.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"18-29"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142782117","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":"Definitive treatment for primary urethral cancer: A single institution's experience with organ-preserving brachytherapy.","authors":"R Merten, V Strnad, A Karius, M Lotter, S Kreppner, C Schweizer, R Fietkau, P Schubert","doi":"10.1016/j.brachy.2024.09.001","DOIUrl":"10.1016/j.brachy.2024.09.001","url":null,"abstract":"<p><strong>Background: </strong>Radical urethectomy ± cystectomy has long represented the standard of care for rare primary urethral cancer (PUC). With our analysis, we want to demonstrate the efficacy and safety of brachytherapy (BT) of urethra for organ preservation.</p><p><strong>Materials and methods: </strong>We analyzed treatment procedures and results of 3 patients with PUC, which have been treated in our department between 2011 and 2020 with brachytherapy. One male patient underwent brachytherapy with chemoradiotherapy after transurethral resection (TUR). Brachytherapy has been performed as high-dose-rate (HDR) boost with a cumulative dose of 8 Gy (9.3 Gy _{EQD2-α/β = 10 Gy}). The 2 further female patients have been treated with sole pulsed-dose-rate (PDR) brachytherapy with a total dose of 49.9 Gy (50.3 Gy _{EQD2-α/β = 10 Gy}) and 62.2 Gy (64.6 Gy _{EQD2-α/β = 10 Gy}).</p><p><strong>Results: </strong>Median follow-up was 103 months (41-153). No local recurrence occurred and all patients are still alive. For the male patient we documented Grade 3 cystitis. As late side effects the pre-existing Grade 2 incontinence worsened to Grade 3. Among female patients one developed Grade 3 vaginal synechiae. There was no Grade ≥4 toxicity.</p><p><strong>Conclusion: </strong>Brachytherapy in PUC is a feasible and promising option with high local control rate and tolerable toxicity. It provides a good alternative to surgery for organ preservation in selected patients.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"62-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395938","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":"Development and implementation of a brachytherapy procedure scoring system to optimize clinic and physics staffing schedule: A retrospective study of a single institution with a busy brachytherapy program.","authors":"Arjit Baghwala, Chengfeng Li, Devin Olek, Forrest Ivey, Ramiro Pino, Andrew Farach","doi":"10.1016/j.brachy.2024.10.007","DOIUrl":"10.1016/j.brachy.2024.10.007","url":null,"abstract":"<p><strong>Purpose: </strong>Brachytherapy (BT) is a time and resource intensive treatment modality. Constraints to efficiency and throughput include resource, staff and physician availability. Herein, we introduce a daily BT procedure scorecard, designed to ensure adequate resource allocation based on the type of procedure(s) being performed.</p><p><strong>Methods: </strong>Data on BT procedures, number of fractions, number of patients, and the average daily caseload from 2021 to 2024 in our clinic were collected. Each BT procedure was assigned a score from 1 to 3 based on complexity and labor intensity, with 1 representing the least and 3 the most complex procedures. This data was then used to evaluate the efficiency of the BT scoring system.</p><p><strong>Results: </strong>Implementing the BT scorecard improved scheduling efficiency without compromising patient throughput. Despite the growth in case complexity, we demonstrated that the scoring system effectively prevents understaffing in our clinics. The goal is to limit the daily BT score to 10 per day when creating the schedule, ensuring balanced resource allocation.</p><p><strong>Conclusion: </strong>The strategies presented can enhance scheduling by ensuring an equitable workload distribution based on the BT schedule. These approaches should be considered in all high-volume BT clinics to optimize patient scheduling and throughput. Additionally, the scoring system allows clinics to develop full-time equivalent (FTE) staffing models that account for patient volume and case types, ensuring optimal resource utilization.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"190-196"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634376","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":"Establishment of an absolute measurement of the reference air kerma rate for HDR ¹⁹²Ir brachytherapy sources.","authors":"Jinpeng Han, Shijie Zhi, Peiwei Wang, Ji Wang, Zhijun Yang, Kun Wang, Xingtao An","doi":"10.1016/j.brachy.2024.09.006","DOIUrl":"10.1016/j.brachy.2024.09.006","url":null,"abstract":"<p><strong>Purpose: </strong>Before this study, no institution in China had undertaken the calculation and official establishment of reference values for the reference air kerma rate associated with high-dose rate ¹⁹²Ir sources used in brachytherapy. This research, carried out at the National Institute of Metrology (NIM) in China, has successfully established an ¹⁹²Ir reference radiation facility. Consequently, it has achieved the absolute measurement of the reference air kerma rate for high-dose rate brachytherapy using ¹⁹²Ir sources.</p><p><strong>Methods and materials: </strong>For this study, a medical afterloader machine was acquired. The radiation source employed was a high-dose rate ¹⁹²Ir source for brachytherapy, produced by HTA Co., Ltd. A reference graphite cavity ionization chamber with a volume of 100 cm³ was designed to serve as the ionization chamber for absolute measurements. The determination of various correction factors and physical constants was achieved through a method that combines Monte Carlo simulations with experimental techniques.</p><p><strong>Results: </strong>The study successfully accomplished the absolute measurement of the reference air kerma rate for the high-dose rate brachytherapy ¹⁹²Ir radiation source. The expanded uncertainty of the measurement results was 0.72% (k = 2). The relative standard deviation for the RAKR of the same ¹⁹²Ir radiation source was 0.073%.</p><p><strong>Conclusions: </strong>This study marks a significant advancement in the field of radiation therapy in China, particularly in the accurate dosimetry for brachytherapy using high-dose rate ¹⁹²Ir sources. The study will contribute to the BIPM.RI(I)-K8 international comparison, organized by the Bureau International des Poids et Mesures (BIPM), thus facilitating the international recognition of the measurement values.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"110-121"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634387","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":"Instant plan quality prediction on transrectal ultrasound for high-dose-rate prostate brachytherapy.","authors":"Tonghe Wang, Yining Feng, Joel Beaudry, David Aramburu Nunez, Daniel Gorovets, Marisa Kollmeier, Antonio L Damato","doi":"10.1016/j.brachy.2024.10.009","DOIUrl":"10.1016/j.brachy.2024.10.009","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Materials and methods: </strong>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).</p><p><strong>Results: </strong>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%.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11738656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications of intravascular brachytherapy.","authors":"Kent Wallner, Kathleen E Kearney, Lorenzo Azzalini, Edward Y Kim, Upendra Parvathaneni, George Sandison, William L Lombardi, Creighton Don, Minsun Kim","doi":"10.1016/j.brachy.2024.11.006","DOIUrl":"10.1016/j.brachy.2024.11.006","url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>PubMed was searched from 1966 through November 21st, 2023, using the terms coronary and brachytherapy, 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.</p><p><strong>Results: </strong>The best documented adverse IVBT-related event is the occurrence of late (> 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"103-109"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","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, Emily Flower, Dylan Richeson, Ikchit Sangha, Tianjun Ma, William Y Song","doi":"10.1016/j.brachy.2024.11.001","DOIUrl":"10.1016/j.brachy.2024.11.001","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"144-153"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","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, Aiswarya Ramachandran, Bolajoko Abidemi Adewara, Ritesh Verma, Vishal Raval, Swathi Kaliki","doi":"10.1016/j.brachy.2024.06.008","DOIUrl":"10.1016/j.brachy.2024.06.008","url":null,"abstract":"<p><strong>Purpose: </strong>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).</p><p><strong>Methods: </strong>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%).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>¹⁰⁶RU plaque brachytherapy can be a useful salvage treatment for focal tumors (new or recurrent) following systemic IVC.</p>","PeriodicalId":93914,"journal":{"name":"Brachytherapy","volume":" ","pages":"76-85"},"PeriodicalIF":0.0,"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":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}