Reirradiation Using Permanent Interstitial Brachytherapy: A Potentially Durable Technique for Salvaging Recurrent Pelvic Malignancies

Feddock, Jonathan; Cheek, D; Steber, C.; Edwards, James; Slone, Stacey; Luo, Wei; Randall, Marcus E.

doi:10.1016/j.ijrobp.2017.08.027

Cited by 19 publications

(31 citation statements)

References 36 publications

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“…Comparable trends were seen with high-dose pelvic second re-irradiation [13]. Only three of nine (33%) pelvic tumors were still controlled at the time of death or of last follow-up, with a median time to failure of 7.7 months.…”

Section: Discussionmentioning

confidence: 81%

“…The historical data were to sparse to draw meaningful conclusions, and were also characterized by a lack of important treatment and outcome parameters. We identified and included nine contemporary studies [10][11][12][13][14][15][17][18][19]. These studies had included 2-25 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Feddock et al utilized permanent interstitial brachytherapy ( 198 Au or 131 Cs) for local recurrences of pelvic malignancies, mostly uterine cancer, in 42 patients [13]. Initial treatment included pelvic radiotherapy with or without brachytherapy and in one case brachytherapy alone.…”

Section: Pelvismentioning

confidence: 99%

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Second re-irradiation: a narrative review of the available clinical data

et al. 2017

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

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Second re-irradiation: a narrative review of the available clinical data

et al. 2017

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“…Nevertheless, data from the literature suggest that hyperfractionation should be considered for locally recurrent rectal cancer [ 18 - 19 ] and possibly also nasopharyngeal cancer [ 20 - 21 ]. Besides fractionation, highly conformal techniques, including brachytherapy, or in some cases proton beam irradiation may be able to reduce the volume of normal tissues exposed to high cumulative total doses [ 5 , 9 , 22 - 24 ]. As illustrated in Case three, the common policy of avoiding elective nodal irradiation in the re-irradiation setting sometimes results in relapses in adjacent nodes, which might be the source of new problems with overlapping target volumes and isodoses.…”

Section: Discussionmentioning

confidence: 99%

Second Re-irradiation: Clinical Examples of Worthwhile Treatment

Nieder

Yobuta

Mannsåker

2018

Cureus

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Introduction: Improved treatment approaches have resulted in longer survival of patients with certain types of incurable cancer, without eliminating the need for symptom palliation and supportive measures. In this context, re-irradiation is an increasingly important option. Little data exists about a second or repeat re-irradiation.Methods: From a single institution database, patients who received a second re-irradiation with cumulative equivalent doses (equivalent dose in 2-Gy fractions (EQD2) for late effects, alpha/beta-value 3 Gy) of more than 90 Gy and survived for more than six months were identified. Illustrative clinical examples were provided.Results: The examples describe the treatment of sacral bone metastases, recurrent rectal cancer, and pelvic lymph node metastases. The maximum cumulative EQD2 was 142 Gy. Symptomatic responses were obtained without clinically relevant side effects.Conclusion: These three cases illustrate that a second re-irradiation has the potential to provide worthwhile palliative effects without causing overt late toxicity during the remaining life time. In patients who tolerated previous radiotherapy well, further re-irradiation may contribute to the ever-increasing armamentarium of options that increase the survival of patients with incurable cancer and try to prolong the time period where independent living is possible.

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“…A small study of 42 patients and 61 implants showed a local control of 73% for initial reirradiation (median time to failure not reached at a follow‐up period of 16.3 months). For second reirradiation, the local control was 33%, with a median time to failure of 7.7 months, and grade ≥3 toxicities were observed in 16.7% of cases 70 . Furthermore, seeds of I‐125 or Pd‐103 have been implanted under CT guidance in patients with rectal cancers recurring after multimodal therapy, with a median dose of 150 Gy.…”

Section: Resultsmentioning

confidence: 99%

Low dose rate permanent seed brachytherapy: tracing its evolution and current status

Banerjee

Kataria

Goyal

et al. 2020

Precision Radiation Oncology

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A recent surge in publications on low dose rate permanent seed brachytherapy prompted us to review the currently available literature in order to provide a summary of the therapy. To this end, we composed a comprehensive review on the available English language publications in PubMed, EMBASE, and Google Scholar. The general principles of seed brachytherapy are discussed, along with radiobiology and technical aspects. Seed brachytherapy has been increasingly used in various sites for primary treatment, and is considered to be particularly useful in cases of reirradiation and otherwise untreatable malignancies. In recent decades, there have been considerable advances in the technology used in seed brachytherapy, including steps to prevent the migration of seeds, reduce personnel exposure to radiation, and use of sophisticated 3-D planning for better dosimetric results, which have ultimately translated into better clinical outputs. Technical advances in seed brachytherapy have lagged behind those in external beam radiotherapy and high dose rate brachytherapy; however, there is renewed interest due to encouraging clinical results in the primary setting, as well as reirradiation for recurrent disease across several sites.

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Reirradiation Using Permanent Interstitial Brachytherapy: A Potentially Durable Technique for Salvaging Recurrent Pelvic Malignancies

Cited by 19 publications

References 36 publications

Second re-irradiation: a narrative review of the available clinical data

Second re-irradiation: a narrative review of the available clinical data

Second Re-irradiation: Clinical Examples of Worthwhile Treatment

Low dose rate permanent seed brachytherapy: tracing its evolution and current status

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