Dosimetric intercomparison of permanent Ho-166 seed's implants and HDR Ir-192 brachytherapy in breast cancer

Campos, Tânia Maria Mendonça; Nogueira, Luciana Batista; Trindade, Bruno Lovaglio Cançado; Cuperschmid, Ethel Mizrahy

doi:10.1016/j.rpor.2015.11.007

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…166 Ho –labelled ceramic seeds have been studied in brain tissue in an animal study and also in a simulation study in human breast tissue (Diniz et al 2017; de Campos et al 2016). The advantages of the 166 Ho-labelled seeds are the high dose rate and not having to remove the seeds after the treatment.…”

Section: Intratumoural Applicationsmentioning

confidence: 99%

“…In a study on brachytherapy in breast cancer by de Campos et al a computational simulation was performed to provide a dosimetric analysis of temporary 192 Ir-labelled seeds compared to permanent 166 Ho-labelled seeds. It was shown that the spatial dose distribution of 166 Ho was confined to the implanted volume, whereas this is not the case for brachytherapy using iridium-192, which is frequently used (de Campos et al 2016). Monte Carlo simulations (Hosseini et al 2013) and MIRD methodology (Valente and Campos 2010) have been used to determine the range and total absorbed dose of 166 Ho-labelled ceramic seeds.…”

Section: Intratumoural Applicationsmentioning

confidence: 99%

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The various therapeutic applications of the medical isotope holmium-166: a narrative review

Klaassen¹,

Arntz²,

Arranja

et al. 2019

EJNMMI radiopharm. chem.

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Over the years, a broad spectrum of applications of the radionuclide holmium-166 as a medical isotope has been established. The isotope holmium-166 is attractive as it emits high-energy beta radiation which can be used for a therapeutic effect and gamma radiation which can be used for nuclear imaging purposes. Furthermore, holmium-165 can be visualized by MRI because of its paramagnetic properties and by CT because of its high density. Since holmium-165 has a natural abundance of 100%, the only by-product is metastable holmium-166 and no costly chemical purification steps are necessary for production of nuclear reactor derived holmium-166. Several compounds labelled with holmium-166 are now used in patients, such Ho 166 -labelled microspheres for liver malignancies, Ho 166 -labelled chitosan for hepatocellular carcinoma (HCC) and [ 166 Ho]Ho DOTMP for bone metastases. The outcomes in patients are very promising, making this isotope more and more interesting for applications in interventional oncology. Both drugs as well as medical devices labelled with radioactive holmium are used for internal radiotherapy. One of the treatment possibilities is direct intratumoural treatment, in which the radioactive compound is injected with a needle directly into the tumour. Numerous other applications have been developed, like patches for treatment of skin cancer and holmium labelled antibodies and peptides. The second major application that is currently clinically applied is selective internal radiation therapy (SIRT, also called radioembolization), a novel treatment option for liver malignancies. This review discusses medical drugs and medical devices based on the therapeutic radionuclide holmium-166.

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Section: Intratumoural Applicationsmentioning

confidence: 99%

Section: Intratumoural Applicationsmentioning

confidence: 99%

The various therapeutic applications of the medical isotope holmium-166: a narrative review

Klaassen¹,

Arntz²,

Arranja

et al. 2019

EJNMMI radiopharm. chem.

View full text Add to dashboard Cite

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“…The implantation of permanent seeds is an alternative brachytherapy technique that relies on the placement of radioactive 'seeds' into the breast to emit low-dose radiotherapy directly into the target. 22 The seeds are inserted post-operatively using hypodermic needles, which is an advantage of this technique in comparison with the aforementioned as a result of the lowered risk of infection. 22 However, this technique has the disadvantage of conferring radioactivity into the patient for an extended period of time (rather than just the duration of the fraction), so caution should be exercised around young children and pregnant women.…”

Section: Permanent Seed Implantationmentioning

confidence: 99%

“…22 The seeds are inserted post-operatively using hypodermic needles, which is an advantage of this technique in comparison with the aforementioned as a result of the lowered risk of infection. 22 However, this technique has the disadvantage of conferring radioactivity into the patient for an extended period of time (rather than just the duration of the fraction), so caution should be exercised around young children and pregnant women. This would not be a concern with WBI or the alternative brachytherapy techniques so could impact negatively on patient QoL.…”

Section: Permanent Seed Implantationmentioning

confidence: 99%

“…This would not be a concern with WBI or the alternative brachytherapy techniques so could impact negatively on patient QoL. 22 Comparison of overall survival and local recurrence rates between brachytherapy and WBI WBI as an adjuvant treatment to BCS improves overall survival both statistically and in a clinically significant way with a published overview of randomised trials showing that radiotherapy halves the risk of recurrence and lowers the rate of breast cancer-related deaths by one-sixth. 23 One of the most important aspects to ascertain when considering interstitial brachytherapy as a safe alternative to WBI is that the outcome in terms of local recurrence and survival rate is not compromised.…”

Section: Permanent Seed Implantationmentioning

confidence: 99%

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A literature review of the role of brachytherapy in the management of early-stage breast cancer

Thorpe

Drury-Smith

2019

J Radiother Pract

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Background:This review evaluates whether brachytherapy can be considered as an alternative to whole breast irradiation (WBI) using criteria such as local recurrence rates, overall survival rates and quality of life (QoL) factors. This is an important issue because of a decline in local recurrence rates, suggesting that some women at very low risk of recurrence may be incurring the negative long-term side effects of WBI without benefitting from a reduction in local recurrence and greater overall survival. As such, the purpose of this literature review is to evaluate whether brachytherapy is a credible alternative to external beam radiation with a particular focus on the impact it has on patient QoL.Methods:The search terms used were devised by using the Population Intervention Comparison Outcome framework, and a literature search was carried out using Boolean connectors and Medical Subject Headings in the PubMed database. The resultant articles were manually assessed for relevance and appraised using the Scottish Intercollegiate Guidelines Network tool. Additional papers were sourced from the citations of articles found using the search strategy. Government guidelines and regulations were also used following a manual search on the National Institute for Health and Care Excellence website. This process resulted in a total of 30 sources being included as part of the review.Results:Three types of brachytherapy were the foundation for the majority of the papers found: interstitial multi-catheter brachytherapy, intra-cavity brachytherapy and permanent seed implantation. The key themes that arose from the literature were that brachytherapy is equivalent to WBI both in terms of 5-year local recurrence rates and overall survival rates at 10–12 years. The findings showed that brachytherapy was superior to WBI for some QoL factors such as being less time-consuming and equal in terms of others such as breast cosmesis. The results did also show that brachytherapy does come with its own local toxicities that could impact upon QoL such as the poor breast cosmesis associated with some brachytherapy techniques.Conclusion:In conclusion, brachytherapy was deemed a safe or acceptable alternative to WBI, but there is a need for further research on the long-term local recurrence rates, survival rates and quality of life issues as the volume of evidence is still significantly smaller for brachytherapy than for WBI. Specifically, there needs to be further investigation as to which patients will benefit from being offered brachytherapy and the influence that factors such as co-morbidities, performance status and patient choice play in these decisions.

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Locoregional Radionuclide Cancer Therapy (LRCT) Using Sealed and Unsealed Radionuclides

Wong

2020

Locoregional Radionuclide Cancer Therapy

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Dosimetric intercomparison of permanent Ho-166 seed's implants and HDR Ir-192 brachytherapy in breast cancer

Cited by 6 publications

References 17 publications

The various therapeutic applications of the medical isotope holmium-166: a narrative review

The various therapeutic applications of the medical isotope holmium-166: a narrative review

A literature review of the role of brachytherapy in the management of early-stage breast cancer

Locoregional Radionuclide Cancer Therapy (LRCT) Using Sealed and Unsealed Radionuclides

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