Rapid Work Flow for Image-Guided Brachytherapy for Gynecological Cancer

CT-on-Rails-Guided HDR Brachytherapy: Single-Room, Rapid-Workflow Treatment Delivery with Integrated Image Guidance

“…Contouring of target volumes and organs at risk, and treatment planning and plan QA are performed prior to HDR delivery. The average time from CT to treatment (58 min) is longer than tandem and ovoid implants [28], but reasonable given the increased complexity of interstitial implant planning compared with an intracavitary implant. After the first fraction of interstitial brachytherapy is complete, the patient is awoken from anesthesia.…”

“…A 3D plan is then prepared based upon available library plans for the specified cylinder diameter and treatment length, and quality assurance (QA) checks are performed. In our practice, the average time from CT scan to treatment start is 13.3 min (range: 8.5-21.5 min) [28], and total time in the brachytherapy suite ranges from 25 to 40 min.…”

“…The average time from CT scan to treatment start is 24.3 min (range: 15.7-36.7 min) [28]; the total time that each patient spends in the brachytherapy suite ranges from 60 to 100 min, including placement of a Smit sleeve in the cervical canal. The subsequent four fractions are performed with mild sedation, rather than general anesthesia, with a new CT scan and plan completed for each insertion.…”