Role of Interstitial Brachytherapy in the Treatment of Malignant Disease

Abstract

Interstitial brachytherapy was first applied using radium needles, with minimum protection of physicians and nurses. Modern techniques involve the use of radionuclide ¹⁹²Ir as the source used in computer-controlled remote afterloading machines, which can deliver a high dose rate (HDR). Treatment planning is also undertaken with the use of computers and anatomical cross-section images using CT, ultrasound and MRI. This review presents these modern techniques for tumors of a series of body sites: prostate, head and neck, breast, bladder, brain, and for soft-tissue sarcomas. Low dose rate (LDR) interstitial brachytherapy techniques are also included in this review since in some body sites there is a choice between HDR and LDR.

Pilomatrix Carcinoma with Lymph Node and Pulmonary Metastases

“…In accordance with treatment data reported in previous cases [2,9,22,23,27,35], the disease appeared resistant to cytotoxic chemotherapy but gratifyingly not resistant to irradiation. In respect of the latter, CT-guided interstitial HDR-BRT [11,12,16] appears to play an important role.…”

“…With the objective of implant upgrading, our reliable BRT method [11,12] is not based on the Paris System [39]. Planning target volume (PTV) and critical structure definition, as well as catheter reconstruction are being performed based on postimplant CT scans.…”

Prognostic Factors in Squamous Cell Carcinoma of the Head and Neck

“…Small tumors are treated primarily by radical surgery, alternatively with brachytherapy in certain sites [25]. However, especially in patients who are not fit for extended surgery, radical radiotherapy alone offers a reasonable alternative.…”

Interstitial high-dose rate brachytherapy as boost for anal canal cancer

“…Standard brachytherapy technique remains based on LDR or PDR [9,10]. However as proposed for numerous tumors (prostate [11] and cervical cancer [12]) HDR brachytherapy appears to be more and more used mainly because of radioprotection considerations, dose distribution optimization and shorter treatment time [13]. Currently, there is few available data focusing on high-dose rate brachytherapy for ACC.…”