Intracavitary/Interstitial Applicator Plus Distal Parametrial Free Needle Interstitial Brachytherapy in Locally Advanced Cervical Cancer: A Dosimetric Study

Qu, Hong-Da; Han, Dongmei; Zhang, Ning; Mao, Zhuang; Cheng, Guanghui

doi:10.3389/fonc.2020.621347

Cited by 4 publications

(7 citation statements)

References 27 publications

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Section: Reviewmentioning

confidence: 99%

“…Similarly, a study by Qu et al (2021) [ 16 ] explored the dosimetric benefit of combining interstitial/intracavitary applicator with distant parametrial free needle interstitial brachytherapy according to the MRI for locally advanced cervical cancer. The study found that combining interstitial/intracavitary applicator with distant parametrial free needle interstitial brachytherapy provides an effective treatment for cervical cancer patients with distal parametrial extension [ 16 ]. Also, the results in Table 2 show that combining intracavitary and interstitial (IC-IS) BT provides a better outcome than using a single treatment approach, as the combination of the approaches was more conformal with minimal regular tissue exposure to intermediate doses [ 18 ].…”

Section: Reviewmentioning

confidence: 99%

“…Similarly, this treatment option helps improve access to care and ensure 100% compliance, as patients can continue with their daily activities as they get their built-in radiation treatment [ 15 ]. Many clinical studies coupled with post-approval utilization have demonstrated the efficacy and safety of GammaTile surgically targeted radiation therapy [ 16 ]. This study aims to conduct a comprehensive literature review on the use of GammaTile surgically targeted radiation therapy (STaRT) for brain tumors.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

GammaTile: Comprehensive Review of a Novel Radioactive Intraoperative Seed-Loading Device for the Treatment of Brain Tumors

Ekhator¹,

Nwankwo²,

Rak³

et al. 2022

Cureus

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GammaTile is a Food and Drug Administration (FDA)-licensed device consisting of four cesium-131 (Cs-131) radiation-emitting seeds in the collagen tile about the postage stamp size. The tiles are utilized to line the brain cavity immediately after tumor resection. GammaTile therapy is a surgically targeted radiation therapy (STaRT) that helps provide instant, dose-intense treatment after the completion of resection. The objective of this study is to explore the safety and efficacy of GammaTile surgically targeted radiation therapy for brain tumors. This study also reviews the differences between GammaTile surgically targeted radiation therapy (STaRT) and other traditional treatment options for brain tumors. The electronic database searches utilized in this study include PubMed, Google Scholar, and ScienceDirect. A total of 4,150 articles were identified based on the search strategy. Out of these articles, 900 articles were retrieved. A total of 650 articles were excluded for various reasons, thus retrieving 250 citations. We applied the exclusion and inclusion criteria to these retrieved articles by screening their full text and excluding 180 articles. Therefore, 70 citations were retrieved and included in this comprehensive literature review, as outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram. Based on the findings of this study, GammaTile surgically targeted radiation therapy (STaRT) is safe and effective for treating brain tumors. Similarly, the findings have also shown that the efficacy of GammaTile therapy can be enhanced by combining it with other standard-of-care treatment options/external beam radiation therapy (EBRT). Also, the results show that patients diagnosed with recurrent glioblastoma (GBM) exhibit poor median overall survival because of the possibility of the tumor returning. Therefore, combining STaRT with other standard-of-care treatment options/EBRT can improve the patient's overall survival (OS). GammaTile therapy enhances access to care, guarantees 100% compliance, and eliminates patients' need to travel regularly to hospitals for radiation treatments. Its implementation requires collaboration from various specialties, such as radiation oncology, medical physics, and neurosurgery.

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Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

GammaTile: Comprehensive Review of a Novel Radioactive Intraoperative Seed-Loading Device for the Treatment of Brain Tumors

Ekhator¹,

Nwankwo²,

Rak³

et al. 2022

Cureus

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“…However, in a study by Qu et al . [ 14 ], the mean depth of insertion of the distal parametrial needle was 6.52 ±2.8 cm, as it was done under ultrasound guidance. Moreover, Liu et al .…”

Section: Discussionmentioning

confidence: 99%

Dosimetric comparison of intra-cavitary brachytherapy technique with free-hand (intra-cavitary + interstitial) technique in cervical cancer

Jamadagni,

Ponni,

2024

jcb

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Purpose The aim of the study was to dosimetrically compare intra-cavitary brachytherapy technique (ICBT) with free-hand (intra-cavitary + interstitial, IC + IS) technique. Material and methods Twenty seven locally advanced carcinoma cervix patients were included in the study. Patients with more than medial 1/3 rd parametrial residual disease without extending upto lateral pelvic wall were included, following external beam radiotherapy (EBRT), in which cobalt-60 high-dose-rate ( 60 Co HDR) brachytherapy source was used. Dose for both plans were 6.5 Gy × 4 fractions, 2 fractions per day, 6 hours apart, over 2 days. Free-hand brachytherapy technique, consisted of placement of central tandem and 2 ovoids along with needles without using template, was applied. Two plans were generated by activating and deactivating the needles, and compared by normalizing to V 100 . Results A total of 79 needles were applied. Using paired- t test, dosimetric comparison of both the plans was done. Free-hand plan had a significant higher mean V 90 (volume receiving 90% of the dose) of 94.2% compared with 87.22% in ICBT plan ( p ≤ 0.0001). Free-hand and ICBT plans presented a mean V 100 values of 89.06% and 81.51% ( p ≤ 0.0001), respectively, favoring free-hand plan. The mean D 90 (dose to 90% volume), D 98 , and D 100 of free-hand plan were 6.28 Gray (Gy), 4.91 Gy, and 3.62 Gy, respectively, but equivalent parameters in ICBT plan were 5.26 Gy, 3.72 Gy, and 2.61 Gy, with p value ≤ 0.0001. In both the plans, D 2cc of the bladder, rectum, and sigmoid were 4.59 Gy, 3.98 Gy, 2.77 Gy, and 4.46 Gy, 3.90 Gy, 2.67 Gy, respectively, with no statistical significance. Conclusions Free-hand brachytherapy (IC + IS) achieves a statistically significant better dose distribution to high-risk clinical target volume (HR-CTV) comparing with ICBT technique with similar dose to organs at risk.

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“…For FIGO stage IIIB-IVA patients with extensive parametrial and/or vaginal tumor extensions that cannot be covered adequately with IC-only BT, an important development was the addition of interstitial (IS) needles to further shape the dose asymmetrically, which has been shown to improve the therapeutic ratio [ 15 , 16 ]. Earlier combined IC/IS techniques involved either trans-perineal or trans-vaginal free-hand implantation of metallic needles, which required considerable skills from the radiation oncologist to accurately reach the target [ 17 ]. This has led to the development of combined IC/IS applicators that use the IC vaginal component as a template to guide straight needles made of either metal or less invasive plastic.…”

Section: Purposementioning

confidence: 99%

The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

Kamio,

Roy,

Morgan

et al. 2023

jcb

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Purpose The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment. Material and methods A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software. This software module was integrated to 3D Brachy, a commercial software developed by Adaptiiv Medical Technologies Inc. For validation of the workflow, CAD models of ground truth caps with five IS needle trajectories were designed with Fusion 360™, 3D-printed, assembled with a split ring applicator, and CT-scanned with radio-opaque markers. 3D Brachy was then applied to generate a replica based on trajectories reconstructed from the radio-opaque markers. A comparison between ground truth and replicated IS needle trajectories was done using intersection points with planes at the level of the cervix (z = 0 cm) and a representative needle depth (z = 3 cm). Results Prototypes of interstitial caps 3D-printed in both BioMed Amber and BioMed Clear SLA resins were tested to be functional both pre- and post-sterilization for IS needles with obliquity angles ≤ 45°. Distance-to-agreement at z = 0 cm and 3 cm as well as deviations in pitch and yaw angles of the five IS needle trajectories were found to have mean values of 3.3 ±2.1 mm, 7.3 ±2.0 mm, 2.9° ±2.3°, and 7.0° ±7.0°, respectively. Conclusions The clinical workflow for image-guided adaptive cervical cancer brachytherapy using the Montreal split ring applicator was validated.

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Intracavitary/Interstitial Applicator Plus Distal Parametrial Free Needle Interstitial Brachytherapy in Locally Advanced Cervical Cancer: A Dosimetric Study

Cited by 4 publications

References 27 publications

GammaTile: Comprehensive Review of a Novel Radioactive Intraoperative Seed-Loading Device for the Treatment of Brain Tumors

GammaTile: Comprehensive Review of a Novel Radioactive Intraoperative Seed-Loading Device for the Treatment of Brain Tumors

Dosimetric comparison of intra-cavitary brachytherapy technique with free-hand (intra-cavitary + interstitial) technique in cervical cancer

The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps

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