Evaluation of the shielding in a treatment room with an electronic brachytherapy unit

Ibanez-Rosello, B.; Bautista-Ballesteros, J.A.; Candela-Juan, Cristian; Villaescusa, J. I.; Ballester, F.; Vijande, J.; Pérez‐Calatayud, José

doi:10.1088/1361-6498/aa56cf

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Esteya ® can be prescribed between 3-5 mm depth and has 5 applicators with of a field size of 10, 15, 20, 25, and 30 mm in diameter. Esteya ® has several design characteristics that make it an excellent tool for treating skin cancer: the Tungsten shielding reduces radiation to healthy tissue to a minimum [ 28 ], overdose at the skin surface is kept to a minimum, workflow is extremely simple, and the source has a guaranteed life time of at least 4000 fractions.…”

Section: Discussionmentioning

confidence: 99%

Two years results of electronic brachytherapy for basal cell carcinoma

Ballester‐Sánchez¹,

Pons-Llanas²,

Candela-Juan³

et al. 2017

jcb

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PurposeThe use of radiation therapy (RT) for non-melanoma skin cancer (NMSC) has been changing throughout the last century. Over the last decades, the use of radiotherapy has surged with the development of new techniques, applicators, and devices. In recent years, electronic brachytherapy (eBT) devices that use small x-ray sources have been introduced as alternative to radionuclide dependence. Nowadays, several devices have been incorporated, with a few series reported, and with a short follow-up, due to the recent introduction of these systems. The purpose of this work is to describe the clinical results of our series after two years follow-up with a specific eBT system.Material and methodsThis is a prospective single-center, non-randomized pilot study, to assess clinical results of electronic brachytherapy in basal cell carcinoma using the Esteya® system. In 2014, 40 patients with 60 lesions were treated. Patient follow-up on a regular basis was performed for a period of two years.ResultsTwenty-six patients with 44 lesions achieved two years follow-up. A complete response was documented in 95.5% of cases. Toxicity was mild (G1 or G2) in all cases, caused by erythema, erosion, or alopecia. Cosmesis was excellent in 88.6% of cases, and good in the rest. Change in pigmentation was the most frequent cosmetic alteration.ConclusionsThis work is special, since the equipment’s treatment voltage was 69.5 kV, and this is the first prospective study with long term follow-up with Esteya®. These preliminary report show excellent results with less toxicity and excellent cosmesis. While surgery has been the treatment of choice, certain patients might benefit from eBT treatment. These are elderly patients with comorbidities or undergoing anticoagulant treatment as well as those who simply refuse surgery or might have other contraindications.

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Section: Discussionmentioning

confidence: 99%

Two years results of electronic brachytherapy for basal cell carcinoma

Ballester‐Sánchez¹,

Pons-Llanas²,

Candela-Juan³

et al. 2017

jcb

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“…Some of the practical advantages of the eBT systems are the reduction of the shielding requirements and the avoidance to replace the radiation source . However, the low energy of the generated x rays, far below the energy range of the HDR radionuclides, results in some drawbacks.…”

Section: Introductionmentioning

confidence: 99%

“…The Esteya eBT system has been studied by other authors, mainly experimentally . The aim of this work is divided into three main objectives: obtaining the phase space at the applicator exit of the Esteya system, exploring some EFEN strategies to achieve a good compromise between reliability and efficiency, and performing a dosimetric characterization of the Esteya system using the obtained phase space.…”

Section: Introductionmentioning

confidence: 99%

A Monte Carlo‐based dosimetric characterization of Esteya^®, an electronic surface brachytherapy unit

Valdes-Cortez

Niatsetski²,

Pérez‐Calatayud

et al. 2018

Medical Physics

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Purpose: The purpose of this work is threefold: First, to obtain the phase space of an electronic brachytherapy (eBT) system designed for surface skin treatments. Second, to explore the use of some efficiency enhancing (EFEN) strategies in the determination of the phase space. Third, to use the phase space previously obtained to perform a dosimetric characterization of the Esteya eBT system. Methods: The Monte Carlo study of the 69.5 kVp x-ray beam of the Esteya â unit (Elekta Brachytherapy, Veenendaal, The Netherlands) was performed with PENELOPE2014. The EFEN strategies included the use of variance reduction techniques and mixed Class II simulations, where transport parameters were fine-tuned. Four source models were studied varying the most relevant parameters characterizing the electron beam impinging the target: the energy spectrum (mono-energetic or Gaussian shaped), and the electron distribution over the focal spot (uniform or Gaussian shaped). Phase spaces obtained were analyzed to detect differences in the calculated data due to the EFEN strategy or the source configuration. Depth dose curves and absorbed dose profiles were obtained for each source model and compared to experimental data previously published. Results: In our EFEN strategy, the interaction forcing variance reduction (VRIF) technique increases efficiency by a factor~20. Tailoring the transport parameters values (C1 and C2) does not increase the efficiency in a significant way. Applying a universal cutoff energy EABS of 10 keV saves 84% of CPU time while showing negligible impact on the calculated results. Disabling the electron transport by imposing an electron energy cutoff of 70 keV (except for the target) saves an extra 8% (losing in the process 1.2% of the photons). The Gaussian energy source (FWHM = 10%, centered at the nominal kVp, homogeneous electron distribution) shows characteristic K-lines in its energy spectrum, not observed experimentally. The average photon energy using an ideal source (mono-energetic, homogeneous electron distribution) was 36.19 AE 0.09 keV, in agreement with the published measured data of 36.2 AE 0.2 keV. The use of a Gaussian-distributed electron source (mono-energetic) increases the penumbra by 50%, which is closer to the measurement results. The maximum discrepancy of the calculated percent depth dose with the corresponding measured values is 4.5% (at the phantom surface, less than 2% beyond 1 mm depth) and 5% (for the 80% of the field) in the dose profile. Our results agree with the findings published by other authors and are consistent within the expected Type A and B uncertainties. Conclusions: Our results agree with the published measurement results within the reported uncertainties. The observed differences in PDD, dose profiles, and photon spectrum come from three main sources of uncertainty: intermachine variations, measurements, and Monte Carlo calculations. It has been observed that a mono-energetic source with a Gaussian electron distribution over the focal spot is a suitable choice to reproduc...

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“…The setup and maintenance costs of electronic brachytherapy (eBT) are lower than those of HDR owing to the low requirements for protection against radiation: no bunker is necessary, and health professionals require minimal personal protection (10)(11)(12). Consequently, eBT could overcome cost-related problems in LMICs.…”

Section: Introductionmentioning

confidence: 99%

Feasibility of electronic brachytherapy in cervix cancer–A dosimetric comparison of different brachytherapy techniques

et al. 2022

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Evaluation of the shielding in a treatment room with an electronic brachytherapy unit

Cited by 5 publications

References 13 publications

Two years results of electronic brachytherapy for basal cell carcinoma

Two years results of electronic brachytherapy for basal cell carcinoma

A Monte Carlo‐based dosimetric characterization of Esteya^®, an electronic surface brachytherapy unit

Feasibility of electronic brachytherapy in cervix cancer–A dosimetric comparison of different brachytherapy techniques

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Evaluation of the shielding in a treatment room with an electronic brachytherapy unit

Cited by 5 publications

References 13 publications

Two years results of electronic brachytherapy for basal cell carcinoma

Two years results of electronic brachytherapy for basal cell carcinoma

A Monte Carlo‐based dosimetric characterization of Esteya®, an electronic surface brachytherapy unit

Feasibility of electronic brachytherapy in cervix cancer–A dosimetric comparison of different brachytherapy techniques

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A Monte Carlo‐based dosimetric characterization of Esteya^®, an electronic surface brachytherapy unit