The Paris System in Interstitial Radiation Therapy

Pierquin, B; Dutreix, A.; Paine, C.H.; Chassagne, D.; Marinello, G.; Ash, D.

doi:10.3109/02841867809127689

Cited by 162 publications

(67 citation statements)

References 4 publications

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“…This result recommends applying slightly shorter active lengths than those used by Anacak et al (21), where the active length in geometrically optimized implants was determined so that the target length should be the same as without optimization. Since the active length in the Paris system should extend significantly beyond the target volume (1,5), by using geometric optimization the active length can be significantly reduced, which may be advantageous in many clinical situations, e.g. in prostate or brain implants, where the reduced implantation depth decreases the incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

“…The rules of the PDS were followed for positioning the catheters (1,5). The single-plane implants included four equidistant parallel catheters, the double-plane implants consisted of eight catheters arranged in a square or seven catheters arranged in equilateral triangle patterns, as seen in the cross-section of the PTV (Fig.…”

Section: Implant Geometries and Target Volumesmentioning

confidence: 99%

“…Later implant techniques were developed using discrete sources either with seeds arranged in ribbons or with a single stepping source. The Paris Dosimetry System (PDS) was originally formulated for wire sources (1,5), but its application is also possible with a high dose rate (HDR) stepping source, when uniform dwell times are used (6,7). The use of a stepping source in HDR brachytherapy, where there is only one source driven by a computer-controlled mechanism, provides more degrees of freedom for shaping the dose distribution, since the source can dwell at almost any location in a catheter for any time.…”

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confidence: 99%

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Evaluation of Geometrically Optimized Single- and Double-plane Interstitial High Dose Rate Implants with Respect to Conformality and Homogeneity

Major

Polgár²,

Fodor³

et al. 2003

Acta Oncologica

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Section: Discussionmentioning

confidence: 99%

Section: Implant Geometries and Target Volumesmentioning

confidence: 99%

mentioning

confidence: 99%

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Evaluation of Geometrically Optimized Single- and Double-plane Interstitial High Dose Rate Implants with Respect to Conformality and Homogeneity

Major

Polgár²,

Fodor³

et al. 2003

Acta Oncologica

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“…The catheters are implanted with an intercatheter spacing of, typically, 10-15 mm in a number of parallel planes depending on the volume to be treated. The catheter cross-section is either in the form of squares or equilateral triangles following the Paris implant dosimetry system, 56 which is also used to determine the number and separation of the catheters. The use of rigid needles obviates the need for CT planning since ideal geometry can be achieved.…”

Section: Breastmentioning

confidence: 99%

Recent developments and best practice in brachytherapy treatment planning

Lee

2014

BJR

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Brachytherapy has evolved over many decades, but more recently, there have been significant changes in the way that brachytherapy is used for different treatment sites. This has been due to the development of new, technologically advanced computer planning systems and treatment delivery techniques. Modern, three-dimensional (3D) imaging modalities have been incorporated into treatment planning methods, allowing full 3D dose distributions to be computed. Treatment techniques involving online planning have emerged, allowing dose distributions to be calculated and updated in real time based on the actual clinical situation. In the case of early stage breast cancer treatment, for example, electronic brachytherapy treatment techniques are being used in which the radiation dose is delivered during the same procedure as the surgery. There have also been significant advances in treatment applicator design, which allow the use of modern 3D imaging techniques for planning, and manufacturers have begun to implement new dose calculation algorithms that will correct for applicator shielding and tissue inhomogeneities. This article aims to review the recent developments and best practice in brachytherapy techniques and treatments. It will look at how imaging developments have been incorporated into current brachytherapy treatment and how these developments have played an integral role in the modern brachytherapy era. The planning requirements for different treatments sites are reviewed as well as the future developments of brachytherapy in radiobiology and treatment planning dose calculation. CHANGES AND DEVELOPMENTS IN TREATMENT PLANNING TECHNIQUESWithin the past few decades, there have been some major changes to the way brachytherapy treatments are both planned and delivered, and the introduction of modern, three dimensional (3D) imaging techniques have contributed significantly. In the 1930s, before the advent of planning computers, treatment planning was carried out by simply following a set of rules according to a dosimetry system such as the Manchester system. [1][2][3] This system was originally developed for use with radium sources and provided information, in tabular form, for the dose specification and distribution of sources and was used for many years. An increase in radiation safety awareness in the 1970s and 1980s led to a decline in the use of radium in favour of the relatively newer and safer radioisotopes such as caesium-137 and iridium-192. Over the same period, technological advances in afterloading techniques and the wider implementation of computerized planning using planar radiographic imaging were being implemented in an attempt to verify the applicator or catheter positions and calculate patient-specific dose. Alongside these advances, the need to compare patients' treatments with those from other treatment centres was being recognized as an important scientific standardization of treatment. The International Commission on Radiation Units and Measurements (ICRU) reports 38 and 58, 4,5 details t...

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“…The needles were inserted below the jaw and medial to the mandible and the plastic catheters were pulled retrogradely through the needles. For implantation, rules of the Paris system were followed [17], i.e. the needles were inserted in single or double plane, giving 5-10 mm margin from all clinically palpable disease.…”

Section: Brachytherapy Technique and Dosementioning

confidence: 99%

High-dose-rate interstitial brachytherapy in early stage oral tongue cancer – 15 year experience from a tertiary care institute

Bansal¹,

Ghoshal²,

Oinam³

et al. 2016

jcb

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Purpose: To determine outcomes of interstitial high-dose-rate brachytherapy (HDR-BT) in patients with early stage oral tongue cancer.Material and methods: Ninety-two patients with stage I and II oral tongue cancer were treated with HDR-BT between 1999 and 2014: brachytherapy alone = 62 (67.4%), and combination of external beam radiotherapy (EBRT) and brachytherapy = 30 (32.6%). Median follow-up was 53.5 months. Patterns of failure, overall survival (OS), disease-free survival (DFS), local control rates (LCR), and nodal control rates (NCR) were determined.Results: 5-year OS, DFS, LCR, and NCR were 73.2%, 58.2%, 64.2%, and 83.8%, respectively. In total, 43 patients (46.7%) failed treatment: isolated local failures = 28 (30.4%), isolated nodal failures = 8 (8.7%), both local and regional failures = 7 (7.6%). While in T1 stage, 5 year LCR were significantly higher in brachytherapy alone group compared to combined EBRT and brachytherapy group (81.7% vs. 62.5%, p = 0.04), the isolated nodal failure rates were not significantly different among the two groups. For T2 stage, NCR were higher in combined EBRT and brachytherapy group compared to brachytherapy alone (92.9% vs. 74.3%). Acute mucositis (grade ≥ 2) was seen more in brachytherapy alone group compared to the combined modality group (87% vs. 66%), and this correlated significantly with the higher biological equivalent dose (BED) in the brachytherapy alone group.Conclusions: Our study recommends treating patients with brachytherapy alone in T1 stage, and demonstrates the need for addressing nodal region either by neck dissection or nodal irradiation in T2 stage patients. Also, the study highlights the need for dose escalation (from the doses used in the study) in both T1 and T2 stage tumors when using interstitial brachytherapy either as sole modality or as a boost.

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The Paris System in Interstitial Radiation Therapy

Cited by 162 publications

References 4 publications

Evaluation of Geometrically Optimized Single- and Double-plane Interstitial High Dose Rate Implants with Respect to Conformality and Homogeneity

Evaluation of Geometrically Optimized Single- and Double-plane Interstitial High Dose Rate Implants with Respect to Conformality and Homogeneity

Recent developments and best practice in brachytherapy treatment planning

High-dose-rate interstitial brachytherapy in early stage oral tongue cancer – 15 year experience from a tertiary care institute

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