A National Referral Service for Paediatric Brachytherapy: An Evolving Practice and Outcomes Over 13 Years
Mark N. GazeNaima SmeuldersR AckwerhClare AllenN BalM BoutrosA ChoGemma EminowiczE GillMatthew W. FittallPaul HumphriesP. LimImran MushtaqT NguyenConnie PeetDouglas PendséSara PolhillHelen ReesGordon SandsAnanth ShankarOlga SlaterTracy SullivanPeter Hoskin
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Most children requiring radiotherapy receive external beam treatment and few have tumours suitable for brachytherapy. No paediatric radiotherapy centre will treat enough patients from its own normal catchment population for expertise in brachytherapy to be developed and sustained. Following discussion and agreement in the national paediatric radiotherapy group, a service for paediatric brachytherapy in the UK has been developed. We report the process that has evolved over more than 10 years, with survival and functional outcome results.Keywords:
External beam radiotherapy
Limiting
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Treatment planning in both teletherapy and brachytherapy is time consuming practice but accurate determination of planning parameters is more important. This paper aims to verify the dose delivery time for the treatment of vaginal cancer, which is a vital parameter of High Dose Rate (HDR) brachytherapy treatment planning. Treatment time has been calculated by the computerized treatment planning system (ABACUS 3.1), and then it has been compared with the manually calculated time. The results obtained are in good agreement. Independent verification of nominal time by two different protocols assures the quality of treatment. This should always be practiced to increase the accuracy of treatment.
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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.
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At the Clatterbridge Centre for Oncology, a single line source brachytherapy technique using the Selectron (Nucletron) low dose rate remote afterloading equipment has been developed for use in conjunction with homogenous whole pelvis external beam radiotherapy in the radical treatment of carcinoma of the cervix. The technique incorporates several modifications aimed at reducing treatment related morbidity while maintaining satisfactory local tumour control and cure rates. A flexible dose prescription system has been devised to allow individualization of the brachytherapy isodose distribution according to the clinical findings and the estimated normal tissue doses. Modifications of source loading distributions are carried out to limit the point "A" dose rate to a narrow range to take into account the dose rate effect on the risk of complications. Source loading distributions are also modified according to the estimated normal tissue doses in order to respect normal tissue tolerance. This paper describes the technique and its underlying principles.
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External beam radiotherapy (EBRT) is a standard treatment for prostate cancer. Despite the development of novel radiotherapy techniques such as intensity-modulated conformal radiotherapy, the risk of local recurrence after EBRT has not been obviated. Various local treatment options (including salvage prostatectomy, brachytherapy, cryotherapy, and high-intensity focused ultrasound [HIFU]) have been employed in cases of local recurrence after primary EBRT. Brachytherapy is the first-line treatment for low-risk and selected intermediate-risk prostate tumors. However, few studies have examined the use of brachytherapy to treat post-EBRT recurrent prostate cancer. The purpose of this paper is to analyze the current state of our knowledge about the effects of salvage brachytherapy in patients who develop locally recurrent prostate cancer after primary EBRT. This article also introduces our novel permanent brachytherapy salvage method.
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ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Aronowitz J, Rivard M. Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions. Journal of Contemporary Brachytherapy. 2014;6(2):185-190. doi:10.5114/jcb.2014.43131. APA Aronowitz, J., & Rivard, M. (2014). Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions. Journal of Contemporary Brachytherapy, 6(2), 185-190. https://doi.org/10.5114/jcb.2014.43131 Chicago Aronowitz, Jesse N., and Mark J. Rivard. 2014. "Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions". Journal of Contemporary Brachytherapy 6 (2): 185-190. doi:10.5114/jcb.2014.43131. Harvard Aronowitz, J., and Rivard, M. (2014). Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions. Journal of Contemporary Brachytherapy, 6(2), pp.185-190. https://doi.org/10.5114/jcb.2014.43131 MLA Aronowitz, Jesse N. et al. "Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions." Journal of Contemporary Brachytherapy, vol. 6, no. 2, 2014, pp. 185-190. doi:10.5114/jcb.2014.43131. Vancouver Aronowitz J, Rivard M. Review paperThe evolution of computerized treatment planning for brachytherapy: American contributions. Journal of Contemporary Brachytherapy. 2014;6(2):185-190. doi:10.5114/jcb.2014.43131.
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