introduction to brachytherapy
DESCRIPTION
Introduction to Brachytherapy. Presentation Overview. What is Cancer? Principles of Radiation Oncology Introduction to Brachytherapy Typical Treatment Process Q & A. Growth. Differentiation. Tissue integrity. What is Cancer ?. Cancer is related to:. TUMOR- cells. CARCINOMA - PowerPoint PPT PresentationTRANSCRIPT
Presentation Overview
What is Cancer?
Principles of Radiation Oncology
Introduction to Brachytherapy
Typical Treatment Process
Q & A
HYPERPLASIE
Healthycells
DYSPLASIEINTERVASATIE
Blood vessel
organ 1
organ 2
Capillary
TUMOR-cells
CARCINOMAIN SITU
TUMOR-cells INVASIEINTERVASATIETRANSPORTTRANSPORTTRANSPORTAANHECHTINGEXTRAVASATIEEXTRAVASATIEMetastasis
RADIOTHERAPY
SURGERY CHEMOTHERAPY
HORMONE-THERAPY
IMMUNOTHERAPY
Cancer Treatment Options
BRACHYTHERAPY
Principles of Radiation Oncology
Damaging cells with radiation until cell repair is not possible anymore
Repair possibility of “normal” tissue is higher than of tumor cells
Cell Sterilization with Ionizing Radiation
Electron microscope image ofmultiplying cells
Cell Nucleus
cellChromosome
Particle
What is Brachytherapy with Remote Afterloading?
Brachytherapy is Greek for:Brachy = short distance, close-in
Therapy = treatment
Remote Afterloading is:Cancer treatment with radioactive sources controlled from a distance
Conformal Brachytherapy
Treat only tumor tissueSpare healthy tissue
Dose is determined by:
Source StrengthExposure TimeSource Position
Brachytherapy: Advantages
Higher local control, due to higher dose to target volume
Less dose to surrounding tissue due to sharp fall-off of radiation dose
Higher treatment dose delivered to the center of the tumor which is more radiation resistant
More conformal treatment due to stepping source technique
Brachytherapy: Disadvantages
Hazard of radiation exposurePotential patient hospitalizationOnly local treatmentSpecial skills and training are neededLicensing and credentialing neededComplete coverage of target volume is essentialSurgical trauma in the case of interstitial techniques
Brachytherapy Delivery Methods
LiquidsPhosphorous (blood disorders)Strontium (bone cancer)Iodine (thyroid)
ImplantsPermanent
(Au-198 or I-125 seeds for prostate)
Temporary (wires or afterloading
techniques)
Brachytherapy Remote Afterloading Methods
Low Dose RateCesium pellets or Iridium wires, treatment 1-3 days
High Dose RateCobalt-60 pellets, Iridium-192 10 Ci source, treatment in minutes
Pulsed Dose RateIridium-192 1 Ci source, treatment 1-3 days
Afterloader: Low Dose Rate (LDR)
Cesium spheres and Iridium wires
no real optimization possible
long treatment times (days)
well known radiobiological and late effects
1978
Afterloader: High Dose Rate (HDR)
Stepping Iridium-192 source (10 Ci)
200+ applicators for body site specific treatments
Programmable variable source positioning via steps and dwell timesShort treatment times (minutes)
1986 - present
Afterloader: Pulsed Dose Rate (PDR)
stepping Iridium source (0.5 - 2Ci)
no limitation to body sites and curvatures
optimization possible
short radiation times (minutes)
long treatment times (days)
requires less shielding
1986 - present
Brachytherapy Components
Imaging devices
Planning Systems
Body-site Specific Applicators
Remote Afterloaders
Treatments by Location
Intracavitary techniques(i.e. Vaginal, Rectum)
Intraluminal techniques(i.e. Lung)
Interstitial techniques(i.e. Breast, Prostate)
Surface applications(i.e. Skin)
Synergy with Brachytherapy
Brachytherapy – External beam
Brachytherapy – SurgeryPer-operative
Pre-operative (improves surgical outcome)
Brachytherapy – Chemotherapy
Brachytherapy - Hyperthermia
Nucletron is the Solution
microSelectron Digital Afterloader for HDR & PDR Body-site Specific SolutionsPLATO & Oncentra Treatment Planning SystemsTraining LeadershipTechnical SupportLicensing Support Reimbursement SupportService