Interstitial High-Dose-Rate Gynecologic Brachytherapy: Clinical Workflow Experience From Three Academic Institutions

Prisciandaro, Joann I.; Zhao, Xiao; Dieterich, Sonja; Hasan, Yasmin; Jolly, Shruti; Al‐Hallaq, Hania

doi:10.1016/j.semradonc.2019.08.001

Cited by 10 publications

(6 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, vaginal template implantation is often used to treat superficial recurrent lesions, such as those in the cervix, vagina, and vaginal stump. Still, for non-central pelvic recurrence lesions, the vaginal template is difficult to implant accurately and its efficacy is discouraging (28).…”

Section: Discussionmentioning

confidence: 99%

Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer

Wang,

Cheng,

Song

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

IntroductionThe prognosis of patients with non-central recurrent cervical cancer (NRCC) remains poor, and treatment options are limited. We aimed to explore the accuracy and safety of the 3D-printed non-coplanar template (3D-PNCT)-assisted 192Ir interstitial brachytherapy (ISBT) in the treatment of NRCC.Material and methodsA total of 36 patients with NRCC who received 3D-PNCT-guided 192Ir ISBT in the First Affiliated Hospital of Zhengzhou University from January 2021 to July 2022 were included in this study. There were 36 3D-PNCTs that were designed and printed. The prescribed dose was 30–36 Gy, divided into five to six times, once a week. To evaluate whether the actual parameters were consistent with the preoperative design, the dosimetric parameters of pre- and postoperative treatment plans were compared, including dose of 90% high-risk clinical target volume (HR-CTV D90), volume percentage of 100% and 150% prescribed dose V100% and V150%, homogeneity index (HI), conformal index (CI), external index (EI), and dose received by 2 cm3 (D2cm3) of the rectum, colon, bladder, and ileum. The safety parameters including occurrence of bleeding, infection, pain, radiation enteritis, and radiation cystitis within 3 months after operation were recorded.ResultsAll patients successfully completed the treatment and achieved the goals of the preoperative plan. There was no significant difference in the accuracy (HRCTVD90, V100%, EI, CI, and HI) and safety (D2cm3 of rectum, colon, bladder, and ileum) parameters of the postoperative plan compared with the preoperative plan (all p>0.05). Major side effects included bleeding at the puncture site (13.9%), postoperative pain (8.3%), acute radiation cystitis (13.9%), and radiation enteritis (19.4%). There were no serious perioperative complications and no grade 3–4 acute radiotherapy side effects.Conclusion3D-PNCT-assisted 192Ir ISBT can be accurately and safely applied in the treatment of patients with NRCC.

show abstract

Section: Discussionmentioning

confidence: 99%

Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer

Wang,

Cheng,

Song

et al. 2023

Front. Oncol.

View full text Add to dashboard Cite

show abstract

“…In the case of postoperative endometrial cancer, the most commonly used brachytherapy is the intracavitary techniques. 17 The patient was diagnosed with complete vaginal septum and required removal of the entire vagina if surgical excision was necessary. It results in significant surgical trauma and affects the quality of life.…”

Section: Discussionmentioning

confidence: 99%

Personalized Brachytherapy for a Herlyn-Werner-Wunderlich Syndrome Patient with Endometrial Cancer: A Case Report

Zeng¹,

Lu²,

Zhang³

et al. 2023

CMAR

View full text Add to dashboard Cite

Endometrial carcinoma (EC) is a common gynecological malignancy. Vaginal cuff brachytherapy (VBT) is an adjuvant treatment for EC. Since a single-channel cylinder sometimes delivers inadequate dose coverage to the vaginal apex, three-dimensional (3D) printing technology can be used to achieve satisfactory dose distribution. Here, we report the first case of an EC patient with Herlyn-Werner-Wunderlich syndrome (HWWS) treated with VBT using 3D-printed applicators. Case Presentation: Here, we present a case study of an endometrial cancer patient with HWWS who underwent surgery. During adjuvant radiotherapy, 3D-printed applicators were used in VBT. To accomplish the reconstruction of the source pathways on magnetic resonance imaging, catheters with copper sulfate were placed in two 3D-printed applicators. The early tolerance of this treatment was positive. During the 6-month follow-up, locoregional recurrence was not detected. Conclusion: Our findings strongly indicate that VBT with 3D-printed applicators may be a reasonable treatment option for EC with HWWS.

show abstract

“…The workflows for interstitial brachytherapy may involve two trans-perineal insertions separated by a week, with two applications of radiation delivered on each insertion (97). The interstitial brachytherapy requires two in-patient stays for each patient, which is a significant load on hospital resources (98).…”

Section: Cervical Cancermentioning

confidence: 99%

Improving Reproducibility and Efficiency of Interstitial HDR Brachytherapy Through MRI-based Targeted Innovations

Shaaer

2023

Preprint

View full text Add to dashboard Cite

Interstitial high dose rate (HDR) brachytherapy is a well-established treatment for prostate and gynecological cancers. HDR brachytherapy involves delivery of a high dose of radiation to the target with minimum dose to the surrounding tissue. Magnetic resonance imaging (MRI) has been explored as a main imaging modality for accurate target identification. Superior soft tissue resolution has been reported with MRI, increasing the accuracy of brachytherapy procedure. Clinical HDR brachytherapy workflows employing MRI are seeing increases in adoption. However, these require additional resources and patient transfers, which increases the planning time and the risk of catheters displacement. In addition, interstitial catheter reconstruction during interstitial brachytherapy procedure is challenging. Thus, accurate and efficient methods of incorporating the MRI imaging in interstitial HDR brachytherapy procedures need to be considered. In this thesis, a robust MRI-based algorithm and workflow were developed for treatment planning of interstitial HDR brachytherapy for prostate and gynecological cancers. An in-house MRI-to Ultrasound image registration algorithm was developed and evaluated for accurate identification of dominant intraprostatic lesions. The dosimetric impact of the registration was also assessed. Furthermore, an in-house MR-line marker was used in evaluating the feasibility of MR-only interstitial gynecological HDR brachytherapy workflow. The impact of the MR-only workflow on the target coverage and normal tissue sparing was evaluated. The dosimetric difference between the conventional approach and the proposed MR-only approaches was also compared and reported. Finally, a deep learning-assisted algorithm was developed for robust catheter reconstruction. The algorithm was benchmarked against the manual reconstruction and their efficiency was evaluated. Based on the results, the MRI-based innovations developed in this work are feasible for implementation in clinical brachytherapy workflows for treatment planning of prostate and gynecological cancers.

show abstract

Interstitial High-Dose-Rate Gynecologic Brachytherapy: Clinical Workflow Experience From Three Academic Institutions

Cited by 10 publications

References 53 publications

Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer

Dosimetric parameters and safety analysis of 3D-printing non-coplanar template-assisted interstitial brachytherapy for non-centrally recurrent cervical cancer

Personalized Brachytherapy for a Herlyn-Werner-Wunderlich Syndrome Patient with Endometrial Cancer: A Case Report

Improving Reproducibility and Efficiency of Interstitial HDR Brachytherapy Through MRI-based Targeted Innovations

Contact Info

Product

Resources

About