Insterstitial hyperthermia and high dose rate brachytherapy in the treatment of anal cancer: A phase I/II study

Kapp, Karin S.; Kapp, Daniel S.; Stuecklschweiger, Georg; Berger, Anton; Geyer, E.

doi:10.1016/0360-3016(94)90157-0

Cited by 18 publications

(9 citation statements)

References 22 publications

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“…The dimensionless heterogeneity coefficient HC has been introduced by Van der Koijk et al (1997) for a comparison of the temperature distributions realized with various interstitial hyperthermia techniques. They showed that systems which provide longitudinal temperature control (hot water tubes (Kapp et al 1993), multi-electrode current source applicators (Van der Koijk et al 1997) and ferromagnetic seeds (Van Wieringen et al 1997b)) are favourable compared with systems with only two-dimensional power steering (microwave antennas (Seegenschmiedt 1993), RF systems (Prionas et al 1994, Ryan et al 1994). However, even with this relative index HC, a direct comparison of the various techniques is hard to make as the geometry and perfusion of the simulated and the treated tissue volumes are not identical.…”

Section: Discussionmentioning

confidence: 99%

Dose uniformity of ferromagnetic seed implants in tissue with discrete vasculature: a numerical study on the impact of seed characteristics and implantation techniques

Wieringen¹,

Kotte²,

Leeuwen³

et al. 1998

Phys. Med. Biol.

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The results from simulations with a new three-dimensional treatment planning system for interstitial hyperthermia with ferromagnetic seeds are presented in this study. The thermal model incorporates discrete vessel structures as well as a heat sink and enhanced thermal conductivity. Both the discrete vessels and the ferroseeds are described parametrically in separate calculation spaces. This parametric description has the advantage of an arbitrary orientation of the structures within the tissue grid, easy manipulation of the structures and independence from the resolution of the tissue voxels (tissue calculation space). The power absorption of the self-regulating seeds is according to empirical data. The thermal effects of an unlimited number of thin layers surrounding the seed (coatings, catheters) can be modelled. The initial calculations have been performed for an array of 12 identical ferromagnetic seeds in a tissue volume with a computer generated artificial vessel network spanning four vessel generations in both the arterial and venous tree. The heterogeneously distributed large isolated vessels impair the temperature distribution significantly, indicating the limited accuracy of continuum models. Simulations with different types of ferromagnetic seeds have confirmed that the efforts of previous studies to optimize the self-regulating temperature control and the implantation techniques of the ferroseeds will improve the homogeneity of the temperature distribution in the target volume. Multifilament seeds implanted in brachytherapy needles and tubular seeds appear to be the most favourable configurations. The division of long seeds into shorter segments with the appropriate Curie temperature will further improve the homogeneity of the temperature distribution without increasing the average temperature in the volume of interest. Given the proper thermal tissue data, the model presented in this study will prove to be a useful tool in making choices for the implant geometry, seed spacing and Curie temperature.

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Section: Discussionmentioning

confidence: 99%

Dose uniformity of ferromagnetic seed implants in tissue with discrete vasculature: a numerical study on the impact of seed characteristics and implantation techniques

Wieringen¹,

Kotte²,

Leeuwen³

et al. 1998

Phys. Med. Biol.

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“…This modality can be part of a preoperative approach for resectable or locally advanced rectal cancers (95)(96)(97)(98) or for unresectable, inoperable, and recurrent disease (99)(100)(101)(102)(103)(104)(105). For anal cancers, HDR brachytherapy can be used as a boost after external beam radiotherapy (106)(107)(108)(109), or as definitive treatment in carefully selected cases.…”

Section: Anorectalmentioning

confidence: 99%

“…The medical physicist supervising the quality improvement program is responsible for documenting the maintenance and repair of remote afterloading units, applicators, and other equipment. (See the ACR Technical Standard for the Performance of Low-Dose-Rate Brachytherapy Physics (106)(107)(108)(109)(110).…”

Section: Other Indicationsmentioning

confidence: 99%

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Erickson

Demanes

Hayes³

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…Several publications have reported on the beneficial effects of combining acutehyperthermia with interstitial brachytherapy [24][25][26][27][28] . There has only been one report of a clinical protocol in which LDMH/LDR thermoradiotherapy has been compared with acute-hyperthermia/LDR thermoradiotherapy 7 .…”

Section: Clinical Ldmh and Brachytherapymentioning

confidence: 99%

Long duration mild temperature hyperthermia and brachytherapy

Armour

Raaphorst

2004

International Journal of Hyperthermia

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Combining long duration mild temperature hyperthermia (LDMH) and low dose-rate (LDR) brachytherapy to enhance therapeutic killing of cancer cells was proposed many years ago. The cellular and tumour research that supports this hypothesis is presented in this review. Research describing LDMH interaction with pulsed brachytherapy and high dose-rate brachytherapy using clinically relevant parameters are compared with LDMH/LDR brachytherapy. The mechanism by which LDMH sensitizes LDR has been established as the inhibition of sublethal damage repair. The molecular mechanisms have been shown to involve DNA repair enzymes, but the exact nature of these processes is still under investigation. The relative differences between LDMH interactions with human and rodent cells are presented to help in the understanding of possible roles of LDMH in clinical application. The role of LDMH in modifying tumour blood flow and its possible role in LDR sensitization of tumours is also presented. The positive aspects of LDMH-brachytherapy for clinical application are sixfold; (1) the thermal goals (temperature, time and volume) are achievable with currently available technology, (2) the hyperthermia by itself has no detectable toxic effects, (3) thermotolerance appears to play a minor if any role in radiation sensitization, (4) TER of around 2 can be expected, (5) hypoxic fraction may be decreased due to blood flow modification and (6) simultaneous chemotherapy may also be sensitized. Combined LDMH and brachytherapy is a cancer therapy that has established biological rationale and sufficient technical and clinical advancements to be appropriately applied. This modality is ripe for clinical testing.

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Insterstitial hyperthermia and high dose rate brachytherapy in the treatment of anal cancer: A phase I/II study

Cited by 18 publications

References 22 publications

Dose uniformity of ferromagnetic seed implants in tissue with discrete vasculature: a numerical study on the impact of seed characteristics and implantation techniques

Dose uniformity of ferromagnetic seed implants in tissue with discrete vasculature: a numerical study on the impact of seed characteristics and implantation techniques

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

Long duration mild temperature hyperthermia and brachytherapy

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