Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

Sharma, Daya Nand; Rath, G.K.; Thulkar, Sanjay; Bahl, Amit; Pandit, Subhas; Julka, P.K.

doi:10.4103/0973-1482.82914

Cited by 18 publications

(10 citation statements)

References 19 publications

(41 reference statements)

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“…Computed tomography (CT-guided) minimally invasive Iridium-192 high-dose-rate (HDR) brachytherapy (BRT) has been introduced as a form of local radiation treatment for inoperable primary and metastatic lung cancer [ 1 , 2 ]. CT-HDRBRT is performed mostly through collaboration with interventional radiologists for insertion of brachytherapy catheters into the tumor [ 3 ].…”

Section: Purposementioning

confidence: 99%

Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?

Chan

Lee

Chiang

et al. 2018

jcb

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PurposeTo provide a pilot dosimetric study of computed tomography (CT)-guided high-dose-rate (HDR) brachytherapy (BRT) and stereotactic body radiotherapy (SBRT) for primary and metastatic lung lesions.Material and methodsFor nine lung primary and metastasis patients, 3D image-based BRT plan using a single virtual catheter was planned for 34 Gy in single fraction to the gross tumor volume (GTV) + 3 mm margin to account for tumor deformation. These plans were compared to margin-based (MB-) and robustness optimized (RO-) SBRT, assuming the same tumor deformation under real-time tumor tracking. Consistent dose calculation was ensured for both BRT and SBRT plans using the same class of collapsed cone convolution superposition algorithm. Plan quality metrics were compared by Friedman tests and Wilcoxon t-tests.Results and ConclusionsBrachytherapy plans showed significant higher GTV mean dose compared to MB- and RO-SBRT (122.2 Gy vs. 50.4 and 44.7 Gy, p < 0.05), and better dose gradient index (R50) = 2.9 vs. 4.3 and 8.4 for MB- and RO-SBRT, respectively. Dose constraints per the RTOG 0915 protocol were achieved for all critical organs except chest wall in BRT. All other dose-volume histograms (DVH) metrics are comparable between BRT and SBRT. Treatment delivery time of BRT and SBRT plans significantly increased and decreased with increasing GTV size, respectively. SBRT using advanced MLC tracking technique and non-coplanar VMAT can achieve comparable dosimetric quality to HDR BRT. Whether or not, the significantly higher GTV dose can increase killing of radioresistant tumor cells and offset the effect of tumor reoxygenation in single fraction BRT, requires further clinical investigation.

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Section: Purposementioning

confidence: 99%

Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?

Chan

Lee

Chiang

et al. 2018

jcb

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“…50 In group A, postoperative bloody sputum was worse than that in preoperation in 1 patient. The CT scan also confirmed the bleeding inside the pulmonary lesions.…”

Section: Discussionmentioning

confidence: 86%

“…Previous studies had found that the incidence of bloody sputum after seed implantation was 0% to 20%. 50 In group A, postoperative bloody sputum was worse than that in preoperation in 1 patient. The CT scan also confirmed the bleeding inside the pulmonary lesions.…”

Section: Discussionmentioning

confidence: 86%

125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

Xiang

Liu

et al. 2015

Medicine

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To investigate the safety and effectiveness of computed tomography (CT)-guided 125I seed implantation for locally advanced nonsmall cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT).We reviewed 78 locally advanced NSCLC patients who had each one cycle of first-line CCRT but had progressive disease identified from January 2006 to February 2015 at our institution. A total of 37 patients with 44 lesions received CT-guided percutaneous 125I seed implantation and second-line chemotherapy (group A), while 41 with 41 lesions received second-line chemotherapy (group B).Patients in group A and B received a total of 37 and 41 first cycle of CCRT treatment. The median follow-up was 19 (range 3–36) months. After the second treatment, the total response rate (RR) in tumor response accounted for 63.6% in group A, which was significantly higher than that of group B (41.5%) (P = 0.033). The median progression-free survival time (PFST) was 8.00 ± 1.09 months and 5.00 ± 0.64 months in groups A and B (P = 0.011). The 1-, 2-, and 3-year overall survival (OS) rates for group A were 56.8%, 16.2%, and 2.7%, respectively. For group B, OS rates were 36.6%, 9.8%, and 2.4%, respectively. The median OS time was 14.00 ± 1.82 months and 10.00 ± 1.37 months for groups A and B, respectively (P = 0.059). Similar toxicity reactions were found in both groups. Tumor-related clinical symptoms were significantly reduced and the patients’ quality of life was obviously improved.CT-guided 125I seed implantation proved to be potentially beneficial in treating localized advanced NSCLC; it achieved good local control rates and relieved clinical symptoms without increasing side effects.

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“…For HDR interstitial brachytherapy of lung lesions, the use of a single brachytherapy catheter in tumors up to a 4 cm diameter, has been previously reported [28,29]. The use of a single catheter showed a 0% complication rate of pneumothorax and a 75% tumor control rate for 20 Gy of prescribed dose in a single fraction [29]. Thus, in this work, four seed positions in a single catheter were used to deliver a 20 Gy single dose to the planning tumor volume (PTV).…”

Section: Plos Onementioning

confidence: 99%

Monte Carlo simulation of the effect of magnetic fields on brachytherapy dose distributions in lung tissue material

et al. 2020

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The aim of this work was to use TOPAS Monte Carlo simulations to model the effect of magnetic fields on dose distributions in brachytherapy lung treatments, under ideal and clinical conditions. Idealistic studies were modeled consisting of either a monoenergetic electron source of 432 keV, or a polyenergetic electron source using the spectrum of secondary electrons produced by 192 Ir gamma-ray irradiation. The electron source was positioned in the center of a homogeneous, lung tissue phantom (ρ = 0.26 g/cm 3). Conversely, the clinical study was simulated using the VariSource VS2000 192 Ir source in a patient with a lung tumor. Three contoured volumes were considered: the tumor, the planning tumor volume (PTV), and the lung. In all studies, dose distributions were calculated in the presence or absence of a constant magnetic field of 3T. Also, TG-43 parameters were calculated for the VariSource and compared with published data from EGS-brachy (EGSnrc) and PENEL-OPE. The magnetic field affected the dose distributions in the idealistic studies. For the monoenergetic and poly-energetic studies, the radial distance of the 10% iso-dose line was reduced in the presence of the magnetic field by 64.9% and 24.6%, respectively. For the clinical study, the magnetic field caused differences of 10% on average in the patient dose distributions. Nevertheless, differences in dose-volume histograms were below 2%. Finally, for TG-43 parameters, the dose-rate constant from TOPAS differed by 0.09% ± 0.33% and 0.18% ± 0.33% with respect to EGS-brachy and PENELOPE, respectively. The geometry and anisotropy functions differed within 1.2% ± 1.1%, and within 0.0% ± 0.3%, respectively. The Lorentz forces inside a 3T magnetic resonance machine during 192 Ir brachytherapy treatment of the lung are not large enough to affect the tumor dose distributions significantly, as expected. Nevertheless, large local differences were found in the lung tissue. Applications of this effect are therefore limited by the fact that meaningful differences appeared only in regions containing air, which is not abundant inside the human.

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Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

Abstract: CT-guided HDRIBT is a safe and feasible non-surgical treatment option for patients with MLL. It provides effective tumor control and needs to be studied further.

Cited by 18 publications

References 19 publications

Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?

Single fraction computed tomography-guided high-dose-rate brachytherapy or stereotactic body radiotherapy for primary and metastatic lung tumors?

125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

Monte Carlo simulation of the effect of magnetic fields on brachytherapy dose distributions in lung tissue material

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