A nomogram to determine required seed air kerma strength in planar Cesium-131 permanent seed implant brachytherapy

Hubley, Emily; Träger, M.; Bar‐Ad, Voichita; Luginbuhl, Adam; Doyle, Laura

doi:10.5114/jcb.2019.82716

Cited by 3 publications

(4 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most low-dose-rate brachytherapy software programs are capable of calculating a basic treatment plan or secondary dose verification for this procedure. Additionally, a nomogram may be an acceptable substitute for a secondary dose calculation in lieu of a formal dose calculation [28]. Point dose dosimetry was applied uniformly to all pre- and post-planning due to the nature of source placement and the inability to accurately decipher source orientation on post-implant imaging.…”

Section: Discussionmentioning

confidence: 99%

“…The seed air kerma strength was iteratively adjusted in the planning software, such that a dose of 60 Gy was delivered to a prescription located 5 mm perpendicular to the center of the implant plane. Planning details have previously been reported [28]. The treatment plan was reviewed by the medical physicist, radiation oncologist, and otorhinolaryngology surgeon.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Single institution implementation of permanent 131Cs interstitial brachytherapy for previously irradiated patients with resectable recurrent head and neck carcinoma

Bar‐Ad

Hubley

Luginbuhl

et al. 2019

jcb

Self Cite

View full text Add to dashboard Cite

Purpose: Permanent interstitial brachytherapy is an appealing treatment modality for patients with locoregional recurrent, resectable head and neck carcinoma (HNC), having previously received radiation. Cesium-131 (131 Cs) is a permanent implant brachytherapy isotope, with a low average photon energy of 30 keV and a short half-life of 9.7 days. Exposure to medical staff and family members is low; patient isolation and patient room shielding are not required. This work presents a single institution's implementation process of utilizing an intraoperative, permanent 131 Cs implant for patients with completely resected recurrent HNC. Material and methods: Fifteen patients receiving 131 Cs permanent seed brachytherapy were included in this analysis. The process of pre-planning, selecting the dose prescription, seed ordering, intraoperative procedures, post-implant planning, and radiation safety protocols are described. Results: Tumor volumes were contoured on the available preoperative PET/CT scans and a pre-implant treatment plan was created using uniform source strength and uniform 1 cm seed spacing. Implants were performed intraoperatively, following tumor resection. In five of the fifteen cases, intraoperative findings necessitated a change from the planned number of seeds and recalculation of the pre-implant plan. The average prescription dose was 56.1 ±6.6 Gy (range, 40-60 Gy). The average seed strength used was 2.2 ±0.2 U (3.5 ±0.3 mCi). Patients returned to a recovery room on a standard surgical floor and remained inpatients, without radiation safety restrictions, based on standard surgical recovery protocols. A post-implant treatment plan was generated based on immediate post-operative CT imaging to verify the seed distribution and confirm delivery of the prescription dose. Patients were provided educational information regarding radiation safety recommendations. Conclusions: Cesium-131 interstitial brachytherapy is feasible and does not pose major radiation safety concerns; it should be considered as a treatment option for previously irradiated patients with recurrent, resectable HNC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Single institution implementation of permanent 131Cs interstitial brachytherapy for previously irradiated patients with resectable recurrent head and neck carcinoma

Bar‐Ad

Hubley

Luginbuhl

et al. 2019

jcb

Self Cite

View full text Add to dashboard Cite

show abstract

“…Pre-implant dosimetry was performed to estimate the number and air kerma strength of seeds required to deliver the prescribed dose to the estimated resection cavity [17]. All patients received a post-implant computed tomography (CT; slice thickness, 0.7-2.0 mm) on a Philips Brilliance 64 or iCT 256, using O-MAR artifact reduction when available.…”

Section: Methodsmentioning

confidence: 99%

“…A point-dose model following the American Association of Physicists in Medicine’s TG-43 dose calculation formalism was used [19]. Details of the pre- and post-implant dosimetry are described in another publication [17]. Inter-seed attenuation effects were not included in the dose calculation [20].…”

Section: Methodsmentioning

confidence: 99%

Carotid dosimetry after re-irradiation with 131Cs permanent implant brachytherapy in recurrent, resected head and neck cancer

Walsh¹,

Hubley²,

Doyle³

et al. 2019

jcb

Self Cite

View full text Add to dashboard Cite

Permanent seed implant cesium-131 (131 Cs) brachytherapy provides highly localized radiation for patients with recurrent head and neck cancer (HNC), who may be ineligible for external beam radiation therapy due to a high-risk of toxicity. As carotid blowout is a concern in the setting of re-irradiation, a dose to the carotid artery was examined for 131 Cs brachytherapy implants. Material and methods: Eleven patients were implanted with 131 Cs adjacent to carotid at the time of resection for recurrent HNC. Vascularized tissue flaps were used in some patients. The carotid artery was contoured on the post-implant brachytherapy treatment plan, and the maximum carotid point dose and minimum carotid-seed distances are reported. The incidence of carotid blowout in the follow-up period was also measured. Results: The maximum carotid dose was 77 ±52 Gy (range, 3-158 Gy). The closest seed to the carotid artery was 0.8 ±0.8 cm (range, 0.2-2.6 cm). One patient without a flap experienced carotid blowout, which was attributed to a non-healing wound rather than to high radiation doses. Conclusions: Carotid artery doses from 131 Cs are reported. Vascularized tissue flaps should be considered when planning 131 Cs brachytherapy.

show abstract

Feasibility of collagen matrix tiles with cesium-131 brachytherapy for use in the treatment of head and neck cancer

et al. 2023

View full text Add to dashboard Cite

A nomogram to determine required seed air kerma strength in planar Cesium-131 permanent seed implant brachytherapy

Cited by 3 publications

References 24 publications

Single institution implementation of permanent 131Cs interstitial brachytherapy for previously irradiated patients with resectable recurrent head and neck carcinoma

Single institution implementation of permanent 131Cs interstitial brachytherapy for previously irradiated patients with resectable recurrent head and neck carcinoma

Carotid dosimetry after re-irradiation with 131Cs permanent implant brachytherapy in recurrent, resected head and neck cancer

Feasibility of collagen matrix tiles with cesium-131 brachytherapy for use in the treatment of head and neck cancer

Contact Info

Product

Resources

About