Palliative Interstitial HDR Brachytherapy for Recurrent Rectal Cancer

Abstract

Interstitial HDR brachytherapy is a valuable tool for the delivery of high doses and achieves effective palliation in recurrent rectal carcinoma.

Feasibility and Early Results of Interstitial Intensity-Modulated HDR/PDR Brachytherapy (IMBT) with/without Complementary External-Beam Radiotherapy and Extended Surgery in Recurrent Pelvic Colorectal Cancer

“…Additionally, introducing IMBT (in other words: individually volume-optimized dose distribution according to target and critical structure volumes -similar to the step-and-shoot technique in intensity-modulated external beam therapy) higher and more conformal dose delivery becomes possible including an excellent intraoperative target definition and the radiobiological advantage of fractionated irradiation [16]. Compared to published HDR IORT or external IORT procedures [1,9,14], the advantages of IMBT include no intraoperative radiation protection and no treatment machines in the operating room are necessary. Relatively low cost, easy handling and the fact, that it does not prolong surgical procedure significantly, are further advantages [17,24].…”

CT-guided interstitial brachytherapy in the local treatment of extrahepatic, extrapulmonary secondary malignancies

“…3) with 70% survival after 12 months demonstrates that other treatment options, either chemotherapy or a local This constellation is typical for oligotopic metastatatic diseases and has also been found for liver metastases [13]. A comparable patient group with recurrent rectal cancer has been treated with CT-guided brachytherapy by Kolotas et al [19]. Here, the achieved local control was also good, and most patients (3/4) died because of distant metastases.…”

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

“…This modality can be part of a preoperative approach for resectable or locally advanced rectal cancers (95)(96)(97)(98) or for unresectable, inoperable, and recurrent disease (99)(100)(101)(102)(103)(104)(105). For anal cancers, HDR brachytherapy can be used as a boost after external beam radiotherapy (106)(107)(108)(109), or as definitive treatment in carefully selected cases.…”