Dosimetric Characteristics of a New Unit for Electronic Skin Brachytherapy

García-Martinez, Teresa; Carmona-Meseguer, V.; Gimeno-Olmos, J.; Lliso-Valverde, F; Palomo-Llinarres, Ruben; Chan, Jan-Pieter; Ballester, F.; Pérez-Calatayud, J.

doi:10.1016/j.brachy.2014.02.233

Cited by 12 publications

(40 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dose gradient for the Esteya ® source is lower than that for the Valencia applicators [25], which results in an even lower dose at the surface, and therefore this maximum skin dose per fraction was never reached either using 7 Gy or 6.1 Gy per fraction.…”

Section: Rationale For the Study Fractionation Schedulesmentioning

confidence: 94%

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

Ballester‐Sánchez¹,

Pons-Llanas

Candela-Juan

et al. 2016

jcb

View full text Add to dashboard Cite

Purpose: Basal cell carcinoma (BCC) is a very common cancer in the Caucasian population. Treatment aims to eradicate the tumor with the lowest possible functional and aesthetic impact. Electronic brachytherapy (EBT) is a treatment technique currently emerging. This study aims to show the outcomes of two consecutive prospective pilot clinical trials using different radiation doses of EBT with Esteya ® EB system for the treatment of superficial and nodular basal cell carcinoma.Material and methods: Two prospective, single-center, non-randomized, pilot studies were conducted. Twenty patients were treated in each study with different doses. The first group (1) was treated with 36.6 Gy in 6 fractions of 6.1 Gy, and the second group (2) with 42 Gy in 6 fractions of 7 Gy. Cure rate, acute toxicity, and late toxicity related to cosmesis were analyzed in the two treatment groups.Results: In group 1, a complete response in 90% of cases was observed at the first year of follow-up, whereas in group 2, the complete response was 95%. The differences with reference to acute toxicity and the cosmetic results between the two treatment groups were not statistically significant.Conclusions: Our initial experience with Esteya ® EB system to treat superficial and nodular BCC shows that a dose of 36.6 Gy and 42 Gy delivered in 6 fraction of 7 Gy achieves a 90% and 95% clinical cure rate at 1 year, respectively. Both groups had a tolerable toxicity and a very good cosmesis. The role of EBT in the treatment of BCC is still to be defined. It will probably become an established option for selected patients in the near future.

show abstract

Section: Rationale For the Study Fractionation Schedulesmentioning

confidence: 94%

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

Ballester‐Sánchez¹,

Pons-Llanas

Candela-Juan

et al. 2016

jcb

View full text Add to dashboard Cite

show abstract

“…The applicators share the same flattening filter (attached to the primary collimator) and a source‐to‐surface distance (SSD) of approximately 60 mm (see Fig. ) …”

Section: Methodsmentioning

confidence: 99%

On the use of the absorbed depth‐dose measurements in the beam calibration of a surface electronic high‐dose‐rate brachytherapy unit, a Monte Carlo‐based study

Valdes-Cortez¹,

Niatsetski²,

Ballester³

et al. 2019

Medical Physics

Self Cite

View full text Add to dashboard Cite

Purpose To evaluate the use of the absorbed depth‐dose as a surrogate of the half‐value layer in the calibration of a high‐dose‐rate electronic brachytherapy (eBT) equipment. The effect of the manufacturing tolerances and the absorbed depth‐dose measurement uncertainties in the calibration process are also addressed. Methods The eBT system Esteya® (Elekta Brachytherapy, Veenendaal, The Netherlands) has been chosen as a proof‐of‐concept to illustrate the feasibility of the proposed method, using its 10 mm diameter applicator. Two calibration protocols recommended by the AAPM (TG‐61) and the IAEA (TRS‐398) for low‐energy photon beams were evaluated. The required Monte Carlo (MC) simulations were carried out using PENELOPE2014. Several MC simulations were performed modifying the flattening filter thickness and the x‐ray tube potential, generating one absorbed depth‐dose curve and a complete set of parameters required in the beam calibration (i.e., HVL, backscatter factor (Bw), and mass energy‐absorption coefficient ratios (µen/ρ)water,air), for each configuration. Fits between each parameter and some absorbed dose‐ratios calculated from the absorbed depth‐dose curves were established. The effect of the manufacturing tolerances and the absorbed dose‐ratio uncertainties over the calibration process were evaluated by propagating their values over the fitting function, comparing the overall calibration uncertainties against reference values. We proposed four scenarios of uncertainty (from 0% to 10%) in the dose‐ratio determination to evaluate its effect in the calibration process. Results The manufacturing tolerance of the flattening filter (±0.035 mm) produces a change of 1.4% in the calculated HVL and a negligible effect over the Bw, (µen/ρ)water,air, and the overall calibration uncertainty. A potential variation of 14% of the electron energies due to manufacturing tolerances in the x‐ray tube (69.5 ± ~10 keV) generates a variation of 10% in the HVL. However, this change has a negligible effect over the Bw and (µen/ρ)water,air, adding 0.1% to the overall calibration uncertainty. The fitting functions reproduce the data with an uncertainty (k = 2) below 1%, 0.5%, and 0.4% for the HVL, Bw, and (µen/ρ)water,air, respectively. The four studied absorbed dose‐ratio uncertainty scenarios add, in the worst‐case scenario, 0.2% to the overall uncertainty of the calibration process. Conclusions This work shows the feasibility of using the absorbed depth‐dose curve in the calibration of an eBT system with minimal loss of precision.

show abstract

“…The Esteya device received FDA approval in 2013 for treatment of a variety of cutaneous malignancies including NMSC and melanoma. Commissioning details for the Axxent [57] and Esteya [58] have been described.…”

Section: New Technology: Electronic Brachytherapymentioning

confidence: 99%

Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

et al. 2015

View full text Add to dashboard Cite

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.

show abstract

Dosimetric Characteristics of a New Unit for Electronic Skin Brachytherapy

Cited by 12 publications

References 21 publications

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

Electronic brachytherapy for superficial and nodular basal cell carcinoma: a report of two prospective pilot trials using different doses

On the use of the absorbed depth‐dose measurements in the beam calibration of a surface electronic high‐dose‐rate brachytherapy unit, a Monte Carlo‐based study

Treatment of Non-Melanomatous Skin Cancer with Radiotherapy

Contact Info

Product

Resources

About