Uniform analysis of dose distribution in interstitial brachytherapy dosimetry systems

Paul, John; Koch, Richard F.; Philip, P.C.

doi:10.1016/0167-8140(88)90032-1

Cited by 10 publications

(3 citation statements)

References 7 publications

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“…First, the central hypoxic area of the tumor, which is closer to the needle, definitely receives a much higher dose (> 50 Gy) as compared to the peripheral portion (20 Gy). [20] This may result in higher tumor control. Second, multiple needles will definitely enhance the risk of complications especially pneumothorax.…”

Section: Discussionmentioning

confidence: 98%

Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

et al. 2011

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Section: Discussionmentioning

confidence: 98%

Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

et al. 2011

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“…Such inhomogeneity, which is not usually acceptable in routine HDRIBT procedures like breast and prostate brachytherapy, actually proves advantageous in liver tumors. Firstly, the central hypoxic area of the tumor, which is closure to needle, definitely receives much higher dose (> 50 Gy for) as compared to the peripheral portion (20 Gy) [21], and therefore may result in higher tumor control. Secondly, multiple needle insertion will definitely enhance the risk of trauma and associated complications.…”

Section: Discussionmentioning

confidence: 99%

High-dose-rate interstitial brachytherapy for liver metastases: first study from India

Sharma

Thulkar²,

Sharma³

et al. 2013

jcb

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PurposeTo study the safety and efficacy of high-dose-rate interstitial brachytherapy (HDRIBT) in patients with liver metastases (LM).Material and methodsBetween 2009 and 2011, 10 patients with 12 metastatic lesions in the liver were enrolled in this prospective trial. All patients had either refused surgery or found ineligible for surgery due to various factors. Under CT guidance, 16 gauze blind end stainless steel or rigid plastic brachytherapy needle was inserted in the center of lesion through the percutaneous route. Generally, a single interstitial brachytherapy (IBT) needle for lesions up to 3 cm and multiple needles for lesions more than 3 cm in diameter were inserted. Treatment was delivered with a single high-dose-rate (HDR) dose of 20 Gy prescribed to the target. The needles were removed immediately after the treatment. The endpoints of study were acute complications and local control of the disease.ResultsThe median size of the lesion was 3.8 cm (2.7-7.0 cm). The average time for the entire IBT procedure was 65 minutes (50-105 minutes). Median follow up was 9 months (3-17 months). None of the patients had fatal complications. Minor complications like pain, nausea/vomiting, and asymptomatic pleural effusion were observed in 3, 2 and 1 patients, respectively. Local control rate at 12 months was 75%. The 1-year local progression free survival (LPFS) was 33%.ConclusionAlthough limited by small sample size, the results of our first study from India suggest that HDRIBT is a safe and effective non surgical option for LM.

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“…This method utilizes needles implanted into the tumor to deliver radiation, thereby minimizing the effects of respiratory motion at the tumor site. To create a homogeneous and conformal target dose, it is common practice to implant multiple needles at equal intervals, parallel to one another, or one needle passing though the center of the clinical target volume (CTV) [ 2 , 3 , 4 , 5 ]. However, if the tumor is in the lung and surrounded by ribs, it is difficult to achieve uniform needle placement [ 6 ], as intercostal spaces are very small and variable (ranging from 5-20 mm) [ 7 ], requiring the use of CT guidance for needle placement.…”

Section: Purposementioning

confidence: 99%

Dosimetric analysis of rib interference of the CTV during interstitial brachytherapy of lung tumors

Yang¹,

Sun²,

Pang³

et al. 2017

jcb

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PurposeIn interstitial brachytherapy for lung tumors, the placement and alignment of the source needles are influenced by the ribs, which can affect the dose distribution. This study evaluated the change in dose to the target by comparing the dose between the actual interstitial brachytherapy plan (AIBP, what is deliverable due to anatomic constraints), and the virtual interstitial brachytherapy plan (VIBP, pretreatment-modified dose distribution).Material and methodsAIBPs and VIBPs were designed for 20 lung tumors. The VIBP was designed with uniform spacing between needles, regardless of the presence of ribs. The prescription dose was 30 Gy. The percentage of normal ipsilateral lung volume that received a dose ≥ 5 Gy (V5), conformity index (COIN), incremental dose percentage (IDP) to the target, and the dose covering 95% (D95) of the clinical target volume (CTV) were calculated.ResultsThe V5 of the VIBPs was significantly smaller than that of the AIBPs (p < 0.01). The mean COIN value was 0.41 ± 0.12 for the AIBPs, which was significantly smaller than the value 0.54 ± 0.12 for the VIBPs (p < 0.01). The D95 of CTV in VIBP-adjusted was greater than that in AIBPs (p < 0.01). The mean IDP was 44% ± 40%. The Dmax of the ribs was 20.16 Gy ± 15.76 Gy in AIBPs, and 18.57 Gy ± 15.14 Gy in VIBPs, which was not significantly different (p > 0.05).ConclusionsThe regular geometric alignment of needles is important for increasing the target dose and limiting the normal lung dose in interstitial brachytherapy for thoracic tumors. Thus, we recommend that radiation oncologists attempt to achieve the regular alignment of needles during implantation.

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Uniform analysis of dose distribution in interstitial brachytherapy dosimetry systems

Cited by 10 publications

References 7 publications

Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

Computerized tomography-guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions

High-dose-rate interstitial brachytherapy for liver metastases: first study from India

Dosimetric analysis of rib interference of the CTV during interstitial brachytherapy of lung tumors

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