The aim of this paper is to discuss brachytherapy treatment and individual applicators suitable for unfavorably localized superficial malignant lesions. Techniques for manufacturing an individual applicator and clinical examples of its use for various locations of cancer are presented. This techniques are based on individual size and shape of the tumour. CT-planning make the technique adequate for individual patient history and type of tumour. Featured techniques seems to be very useful and easy to performed.

PurposeEndobronchial brachytherapy (EB) is one way of treatment of patients with advanced lung cancer. Technological progress and the introduction of computed tomography for use in 3D planning allows one to define the area being treated very precisely, which gives an opportunity to extend survival, even in groups of patients receiving palliative care.Material and methodsIn 2011, in the Brachytherapy Department of the Subcarpathian Oncological Center, a group of 12 consecutive patients with advanced cancer of the bronchus underwent palliative EB. We compared the coverage of GTV (gross tumor volume), seen in the computed tomography study with intravenous contrast, by the PTV (planning target volume) planned in 3D and 2D.ResultsIn 2D planning GTV coverage ranged from 15% to 89%. By analyzing the isodose of 90%, it was found that 2D planning covered GTV in 15-35% of the dose. In 3D planning, this coverage changed positively, and ranged from 85% to 100%. The GTV coverage in 3D planning was 100% by definition. In addition, it should be noted that in the 3D planning one can spare critical organs or pacemakers.ConclusionsPlanning for HDR brachytherapy in all locations should be based on dynamic imaging at present, especially in centers that are equipped with CT. Evaluation should be a routine test in treatment planning. The use of CT, even in palliative treatment planning, allows for much better coverage of GTV areas as well, which is very important to reduce radiation doses to critical organs and thereby reduce the toxic effects of treatment.

PurposeTo present comparison of treatment plans made by using 2D and 3D methods in the planning system, as well as to assess the quality of treatment plans using the 2D and 3D methods.Material and methodsThe studies involved a group of 31 patients with advanced lung cancer treated in the Brachytherapy Department of the Subcarpathian Cancer Center in Brzozów from 2011 to 2013. In total, 31 patients and 76 treatment plans were analyzed. We compared coverage of PTV planned in 3D and 2D. In the 3D method of treatment, three-dimensional images from computer tomography were used. In treatment plans performed using the 2D method, images from the simulator were used.ResultsThe comparison of treatment plans made by using 2D and 3D methods is described. This comparison highlighted the significant differences between these two methods assessing reference dose coverage of the PTV by 100% and 85% isodose.ConclusionsReference doses with 100% coverage of the PTV in treatment applied with the 3D method are 31% higher than when applied with the 2D method.

Treatment planning in High Dose Rate (HDR) brachytherapy based on three-dimensional (3D) imaging allows for prearranging and realization optimal treatment process. This process consists of procedure planning, the choice of applicators, adjusting the appropriate implantation technique, and planning of three-dimensional distribution of dose in computerized treatment planning system. 3D images used in treatment planning in HDR brachytherapy allows for choosing the most appropriate application technique. This in turn allows for the best area coverage by reference dose with simultaneous protection of critical organs. Treatment planning on 3D images assures individual planning of dose dispersion in target area. Several techniques will be presented based on 3D imaging in location such as lung, skin cancer, breast, and prostate cancer. For each location, relative cases will be provided where different applicators and techniques were applied. These examples are going to present images from before and after performed application along with the pictures from computer treatment planning system. In each of described locations, relative advice and rules of conducting accurate application will be provided.

The aim of this paper is to discuss brachytherapy treatment and individual applicators suitable for unfavorably localized superficial malignant lesions. Techniques for manufacturing an individual applicator and clinical examples of its use for various locations of cancer are presented. This techniques are based on individual size and shape of the tumour. CT-planning make the technique adequate for individual patient history and type of tumour. Featured techniques seems to be very useful and easy to performed.