The use of brachytherapy in the treatment of nonmelanoma skin cancer: A review

Alam, Murad; Nanda, Shivani; Mittal, Bharat B.; Kim, Natalie A.; Yoo, Simon

doi:10.1016/j.jaad.2010.03.027

Cited by 85 publications

(64 citation statements)

References 26 publications

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“…With LDR interstitial brachytherapy, patients must be hospitalized throughout treatment, which may limit the circumstances under which this modality is used [14].…”

Section: Indications For Radiotherapy In Nmscmentioning

confidence: 99%

“…The three mainstay treatment modalities for external beam therapy are orthovoltage RT, electron beam RT, and megavoltage photons [13]. Brachytherapy has been applied as a surface mold or implanted interstitially [14]. As we will see in a later section, there are also newer technologies, such as electronic brachytherapy, which represent additional tools in the clinician's arsenal [15].…”

Section: Introductionmentioning

confidence: 99%

“…Surface molds may provide highdose rate (HDR) or low-dose rate (LDR) irradiation. HDR is highly fractionated while LDR is typically delivered as a single fraction [14].…”

Section: Introductionmentioning

confidence: 99%

“…Due to its invasive nature, interstitial brachytherapy is given in LDR form for a single treatment lasting around 2-6 days, depending on the prescribed dose [14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

et al. 2015

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Non-melanomatous skin cancer (NMSC) is the leading cause of cancer in the United States. Treatment with surgical excision is considered the gold standard, but radiotherapy is an excellent alternative to surgical excision. Radiotherapy for NMSC takes many forms including a variety of external beam treatments as well as brachytherapy. Radiotherapy is indicated in a broad range of patients and is particularly useful in elderly patients who are poor surgical candidates or prefer not to have surgery. Radiotherapy is also employed in certain cases of recurrence and perineural invasion and when margin control is a concern. In addition to discussing standard techniques and indications for radiotherapy, this article will review specific considerations for radiotherapy in the treatment of basal cell carcinoma and squamous cell carcinoma. Finally, the article will examine new developments in the treatment of NMSC with radiotherapy including electronic brachytherapy and Helical TomoTherapy.

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“…With LDR interstitial brachytherapy, patients must be hospitalized throughout treatment, which may limit the circumstances under which this modality is used [14].…”

Section: Indications For Radiotherapy In Nmscmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Surface molds may provide highdose rate (HDR) or low-dose rate (LDR) irradiation. HDR is highly fractionated while LDR is typically delivered as a single fraction [14].…”

Section: Introductionmentioning

confidence: 99%

“…Due to its invasive nature, interstitial brachytherapy is given in LDR form for a single treatment lasting around 2-6 days, depending on the prescribed dose [14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

et al. 2015

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“…112 Of course, much has changed since those pioneering days, but the principle of applying a radiation source to the skin to kill tumour cells is still as valid today. Nonmelanoma skin cancers are the most common among the Caucasian population, 113 with almost 100,000 cases diagnosed in the UK alone each year. There are many different treatment modalities, including surgery, megavoltage X-rays and electrons and orthovoltage X-rays, but the inherent advantages of brachytherapy and the dominance of the inverse square law results in a rapid fall-off in doses beyond the tumour enabling skin lesions to be treated with tumourcidal doses, while sparing the sensitive, underlying structures.…”

Section: 103mentioning

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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