Endoluminal and Interstitial Brachytherapy for the Treatment of Gastrointestinal Malignancies: a Systematic Review

Abstract

Radiation therapy is an integral component in the multimodality management of many gastrointestinal (GI) cancers at all stages of clinical presentation. With recent advances in technology and radiation delivery, external beam radiation therapy (EBRT) can be delivered with reduced toxicity. However, despite these advances, EBRT doses are still limited by the presence of radiosensitive serial structures near clinical targets in the GI tract. Relative to EBRT techniques, brachytherapy techniques have a lower integral dose and more rapid fall-off, allowing for high-dose delivery with little normal tissue exposure. Given the unique characteristics of brachytherapy, it is an attractive strategy to treat GI malignancies. This review addresses the application of both high-dose rate brachytherapy (HDRBT) and low-dose rate brachytherapy (LDRBT) to multiple GI malignancies for both definitive and palliative management.

Radiation in Gastroenterology

“…In permanent IBRT, radioactive implants (seeds, wires, pellets, capsules, or rods) are permanently placed and lose their activity after a few months. IBRT is used for the definitive or palliative treatment of various GI malignancies, which include esophageal, rectal, anal, hepatic, and biliary malignancies [ 17 ]. Endoscopic ultrasound (EUS)-guided interstitial brachytherapy can be given in patients with advanced pancreatic cancer [ 18 ].…”