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de Prez L, Avilés Lucas P, Kok E. A formalism for traceable dosimetry in superficial electronic brachytherapy (eBT). Phys Med Biol 2023; 68:175025. [PMID: 37451251 DOI: 10.1088/1361-6560/ace7a9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/14/2023] [Indexed: 07/18/2023]
Abstract
Objective. Despite the number of treatments performed with electronic brachytherapy (eBT) there is no uniform methodology for reference dosimetry for international traceability to primary dosimetry standards in different eBT systems. The objective of this study is to propose a formalism for traceability reference dosimetry in superficial eBT, that is easy to apply in the clinic. This method was investigated for an Elekta Esteya with one applicator.Approach. The calibration x-ray spectrum at the primary standards dosimetry laboratory was matched to the measured eBT photon spectrum. Subsequently, two ionization chambers of different types were calibrated at the primary standard dosimetry laboratory (PSDL) in terms of air kerma against a primary standard. The chambers were used to measure ionization chamber reading ratios in-air at different distances from the applicator. Monte Carlo based air kerma ratios were calculated at different positions from the eBT applicator as well as backscatter factors in water and average mass energy absorption ratios in water and in air. Relative measurements with radiochromic films were performed in a water phantom to determine the ratio of absorbed dose to water,Dw, at the surface toDwat 1 cm depth in water. These were compared with Monte Carlo calculations.Main results. Calculations and measurements were combined to estimate theDwat the surface and at 1 cm depth in water. Ionization chamber agreement of the surface dose was 1.7%, within an uncertainty of 6.8% (k= 2). They agreed with the manufacturer dosimetry within 1.8%, with an uncertainty of 5.0% (k= 2). The feasibility of the formalism and methodology for the Esteya system was demonstrated.Significance. This study proposes a method for harmonization of traceable reference dosimetry for eBT contact treatments which does not involve a detailed simulation of the ionization chamber. The method demonstrated feasibility for one eBT system using one surface applicator. In the future the method could be applied for different eBT systems.
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Affiliation(s)
- Leon de Prez
- VSL-National Metrology Institute, Delft, NL, The Netherlands
| | | | - Elfried Kok
- VSL-National Metrology Institute, Delft, NL, The Netherlands
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2
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Manna F, Pugliese M, Buonanno F, Gherardi F, Iannacone E, La Verde G, Muto P, Arrichiello C. Use of Thermoluminescence Dosimetry for QA in High-Dose-Rate Skin Surface Brachytherapy with Custom-Flap Applicator. SENSORS (BASEL, SWITZERLAND) 2023; 23:3592. [PMID: 37050652 PMCID: PMC10098582 DOI: 10.3390/s23073592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
Surface brachytherapy (BT) lacks standard quality assurance (QA) protocols. Commercially available treatment planning systems (TPSs) are based on a dose calculation formalism that assumes the patient is made of water, resulting in potential deviations between planned and delivered doses. Here, a method for treatment plan verification for skin surface BT is reported. Chips of thermoluminescent dosimeters (TLDs) were used for dose point measurements. High-dose-rate treatments were simulated and delivered through a custom-flap applicator provided with four fixed catheters to guide the Iridium-192 (Ir-192) source by way of a remote afterloading system. A flat water-equivalent phantom was used to simulate patient skin. Elekta TPS Oncentra Brachy was used for planning. TLDs were calibrated to Ir-192 through an indirect method of linear interpolation between calibration factors (CFs) measured for 250 kV X-rays, Cesium-137, and Cobalt-60. Subsequently, plans were designed and delivered to test the reproducibility of the irradiation set-up and to make comparisons between planned and delivered dose. The obtained CF for Ir-192 was (4.96 ± 0.25) μC/Gy. Deviations between measured and TPS calculated doses for multi-catheter treatment configuration ranged from -8.4% to 13.3% with an average of 0.6%. TLDs could be included in clinical practice for QA in skin BT with a customized flap applicator.
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Affiliation(s)
- Francesco Manna
- Department of Physics “E. Pancini”, Federico II University, 80126 Naples, Italy
- Centro Servizi Metrologici e Tecnologici Avanzati, Federico II University, 80146 Naples, Italy
| | - Mariagabriella Pugliese
- Department of Physics “E. Pancini”, Federico II University, 80126 Naples, Italy
- National Institute of Nuclear Physics, Section of Naples, 80126 Naples, Italy
| | - Francesca Buonanno
- Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, 80131 Naples, Italy
| | - Federica Gherardi
- Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, 80131 Naples, Italy
| | - Eva Iannacone
- Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, 80131 Naples, Italy
| | - Giuseppe La Verde
- Department of Physics “E. Pancini”, Federico II University, 80126 Naples, Italy
- National Institute of Nuclear Physics, Section of Naples, 80126 Naples, Italy
| | - Paolo Muto
- Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, 80131 Naples, Italy
| | - Cecilia Arrichiello
- Radiotherapy Unit, Istituto Nazionale Tumori, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Fondazione G. Pascale, 80131 Naples, Italy
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Valdes‐Cortez C, Niatsetski Y, Perez‐Calatayud J, Ballester F, Vijande J. A Monte Carlo study of the relative biological effectiveness in surface brachytherapy. Med Phys 2022; 49:5576-5588. [DOI: 10.1002/mp.15774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 11/07/2022] Open
Affiliation(s)
| | - Yury Niatsetski
- R&D Elekta Brachytherapy Waardgelder 1, 3905 TH Veenendaal The Netherlands
| | - Jose Perez‐Calatayud
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Radiotherapy Department La Fe Hospital Valencia Spain
- Radiotherapy Department Hospital Clinica Benidorm Alicante Spain
| | - Facundo Ballester
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Department of Atomic, Molecular and Nuclear Physics University of Valencia Burjassot Spain
| | - Javier Vijande
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED) Instituto de Investigación Sanitaria La Fe (IIS‐La Fe)‐Universitat de Valencia (UV)
- Department of Atomic, Molecular and Nuclear Physics University of Valencia Burjassot Spain
- Instituto de Física Corpuscular IFIC (UV‐CSIC) Burjassot Spain
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Valdes-Cortez C, Ballester F, Vijande J, Gimenez V, Gimenez-Alventosa V, Perez-Calatayud J, Niatsetski Y, Andreo P. Depth-dose measurement corrections for the surface electronic brachytherapy beams of an Esteya ® unit: a Monte Carlo study. Phys Med Biol 2020; 65. [DOI: 10.1088/1361-6560/ab9773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/28/2020] [Indexed: 11/12/2022]
Abstract
Abstract
Three different correction factors for measurements with the parallel-plate ionization chamber PTW T34013 on the Esteya electronic brachytherapy unit have been investigated. This chamber type is recommended by AAPM TG-253 for depth-dose measurements in the 69.5 kV x-ray beam generated by the Esteya unit.
Monte Carlo simulations using the PENELOPE-2018 system were performed to determine the absorbed dose deposited in water and in the chamber sensitive volume at different depths with a Type A uncertainty smaller than 0.1%. Chamber-to-chamber differences have been explored performing measurements using three different chambers. The range of conical applicators available, from 10 to 30 mm in diameter, has been explored.
Using a depth-independent global chamber perturbation correction factor without a shift of the effective point of measurement yielded differences between the absorbed dose to water and the corrected absorbed dose in the sensitive volume of the chamber of up to 1% and 0.6% for the 10 mm and 30 mm applicators, respectively. Calculations using a depth-dependent perturbation factor, including or excluding a shift of the effective point of measurement, resulted in depth-dose differences of about ± 0.5% or less for both applicators. The smallest depth-dose differences were obtained when a shift of the effective point of measurement was implemented, being displaced 0.4 mm towards the center of the sensitive volume of the chamber. The correction factors were obtained with combined uncertainties of 0.4% (k = 2). Uncertainties due to chamber-to-chamber differences are found to be lower than 2%.
The results emphasize the relevance of carrying out detailed Monte Carlo studies for each electronic brachytherapy device and ionization chamber used for its dosimetry.
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Fulkerson RK, Perez‐Calatayud J, Ballester F, Buzurovic I, Kim Y, Niatsetski Y, Ouhib Z, Pai S, Rivard MJ, Rong Y, Siebert F, Thomadsen BR, Weigand F. Surface brachytherapy: Joint report of the AAPM and the GEC‐ESTRO Task Group No. 253. Med Phys 2020; 47:e951-e987. [DOI: 10.1002/mp.14436] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Regina K. Fulkerson
- Department of Medical Physics University of Wisconsin–Madison Madison WI53705 USA
| | - Jose Perez‐Calatayud
- Radiotherapy Department La Fe Hospital Valencia46026 Spain
- Radiotherapy Department Clinica Benidorm Alicante03501 Spain
| | - Facundo Ballester
- Department of Atomic, Molecular and Nuclear Physics University of Valencia Burjassot46100 Spain
| | - Ivan Buzurovic
- Dana‐Farber/Brigham and Women’s Cancer Center Harvard Medical School Boston MA02115 USA
| | - Yongbok Kim
- Department of Radiation Oncology University of Arizona Tucson AZ85724 USA
| | - Yury Niatsetski
- R&D Elekta Brachytherapy Waardgelder 1 Veenendaal3903 DD Netherlands
| | - Zoubir Ouhib
- Radiation Oncology Department Lynn Regional Cancer CenterBoca Raton Community Hospital Boca Raton FL33486 USA
| | - Sujatha Pai
- Radion Inc. 20380 Town Center Lane, Suite 135 Cupertino CA95014 USA
| | - Mark J. Rivard
- Department of Radiation Oncology Alpert Medical School Brown University Providence RI02903 USA
| | - Yi Rong
- Department of Radiation Oncology University of California Davis Comprehensive Cancer Center Sacramento CA95817 USA
| | - Frank‐André Siebert
- UK S‐HCampus Kiel, Klinik fur Strahlentherapie (Radioonkologie) Arnold‐Heller‐Str. 3Haus 50 KielD‐24105 Germany
| | - Bruce R. Thomadsen
- Department of Medical Physics University of Wisconsin–Madison Madison WI53705 USA
| | - Frank Weigand
- Carl Zeiss Meditec AG Rudolf‐Eber‐Straße 11 Oberkochen73447 Germany
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Valdes-Cortez C, Niatsetski Y, Ballester F, Vijande J, Candela-Juan C, Perez-Calatayud J. On the use of the absorbed depth-dose measurements in the beam calibration of a surface electronic high-dose-rate brachytherapy unit, a Monte Carlo-based study. Med Phys 2019; 47:693-702. [PMID: 31722113 DOI: 10.1002/mp.13920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 11/06/2019] [Accepted: 11/06/2019] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To evaluate the use of the absorbed depth-dose as a surrogate of the half-value layer in the calibration of a high-dose-rate electronic brachytherapy (eBT) equipment. The effect of the manufacturing tolerances and the absorbed depth-dose measurement uncertainties in the calibration process are also addressed. METHODS The eBT system Esteya® (Elekta Brachytherapy, Veenendaal, The Netherlands) has been chosen as a proof-of-concept to illustrate the feasibility of the proposed method, using its 10 mm diameter applicator. Two calibration protocols recommended by the AAPM (TG-61) and the IAEA (TRS-398) for low-energy photon beams were evaluated. The required Monte Carlo (MC) simulations were carried out using PENELOPE2014. Several MC simulations were performed modifying the flattening filter thickness and the x-ray tube potential, generating one absorbed depth-dose curve and a complete set of parameters required in the beam calibration (i.e., HVL, backscatter factor (Bw ), and mass energy-absorption coefficient ratios (µen /ρ)water,air ), for each configuration. Fits between each parameter and some absorbed dose-ratios calculated from the absorbed depth-dose curves were established. The effect of the manufacturing tolerances and the absorbed dose-ratio uncertainties over the calibration process were evaluated by propagating their values over the fitting function, comparing the overall calibration uncertainties against reference values. We proposed four scenarios of uncertainty (from 0% to 10%) in the dose-ratio determination to evaluate its effect in the calibration process. RESULTS The manufacturing tolerance of the flattening filter (±0.035 mm) produces a change of 1.4% in the calculated HVL and a negligible effect over the Bw , (µen /ρ)water,air , and the overall calibration uncertainty. A potential variation of 14% of the electron energies due to manufacturing tolerances in the x-ray tube (69.5 ± ~10 keV) generates a variation of 10% in the HVL. However, this change has a negligible effect over the Bw and (µen /ρ)water,air , adding 0.1% to the overall calibration uncertainty. The fitting functions reproduce the data with an uncertainty (k = 2) below 1%, 0.5%, and 0.4% for the HVL, Bw , and (µen /ρ)water,air , respectively. The four studied absorbed dose-ratio uncertainty scenarios add, in the worst-case scenario, 0.2% to the overall uncertainty of the calibration process. CONCLUSIONS This work shows the feasibility of using the absorbed depth-dose curve in the calibration of an eBT system with minimal loss of precision.
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Affiliation(s)
- Christian Valdes-Cortez
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Valencia (UV), Valencia, 46100, Spain.,Radiotherapy Department, Centro Oncológico del Norte, Antofagasta, 1240000, Chile
| | - Yury Niatsetski
- R&D Elekta Brachytherapy, Waardgelder 1, 3905 TH, Veenendaal, The Netherlands
| | - Facundo Ballester
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Valencia (UV), Valencia, 46100, Spain.,IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain
| | - Javier Vijande
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Valencia (UV), Valencia, 46100, Spain.,IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain
| | - Cristian Candela-Juan
- Centro Nacional de Dosimetría (CND), Instituto Nacional de Gestión Sanitaria, Valencia, 46009, Spain
| | - Jose Perez-Calatayud
- IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain.,Radiotherapy Department, La Fe Hospital, Valencia, 46026, Spain
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7
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Valdes-Cortez C, Niatsetski Y, Perez-Calatayud J, Ballester F, Vijande J. A Monte Carlo-based dosimetric characterization of Esteya®
, an electronic surface brachytherapy unit. Med Phys 2018; 46:356-369. [DOI: 10.1002/mp.13275] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/07/2018] [Accepted: 10/23/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- Christian Valdes-Cortez
- Department of Atomic, Molecular and Nuclear Physics; University of Valencia; Burjassot 46100 Spain
- Radiotherapy Department; Centro Oncológico de Antofagasta; Los Pumas 10255 Antofagasta Chile
| | - Yury Niatsetski
- R&D Elekta Brachytherapy; Waardgelder 1 3905 TH Veenendaal The Netherlands
| | - Jose Perez-Calatayud
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED); Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV); E-46026 Valencia Spain
- Radiotherapy Department; La Fe Hospital; E-46026 Valencia Spain
| | - Facundo Ballester
- Department of Atomic, Molecular and Nuclear Physics; University of Valencia; Burjassot 46100 Spain
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED); Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV); Burjassot 46100 Spain
| | - Javier Vijande
- Department of Atomic, Molecular and Nuclear Physics; University of Valencia; Burjassot 46100 Spain
- Unidad Mixta de Investigación en Radiofísica e Instrumentación Nuclear en Medicina (IRIMED); Instituto de Investigación Sanitaria La Fe (IIS-La Fe)-Universitat de Valencia (UV); Burjassot 46100 Spain
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8
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Torres del Río J, Forastero C, Tornero-López AM, López JJ, Guirado D, Perez-Calatayud J, Lallena AM. Air density dependence of the soft X-ray PTW 34013 ionization chamber. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.01.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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9
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Ibanez-Rosello B, Bautista-Ballesteros JA, Candela-Juan C, Villaescusa JI, Ballester F, Vijande J, Perez-Calatayud J. Evaluation of the shielding in a treatment room with an electronic brachytherapy unit. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:N5-N12. [PMID: 28253202 DOI: 10.1088/1361-6498/aa56cf] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Esteya® (Elekta Brachytherapy, Veenendaal, The Netherlands) is an electronic brachytherapy (eBT) system based on a 69.5 kVp x-ray source and a set of collimators of 1 to 3 cm in diameter, used for treating non-melanoma skin cancer lesions. This study aims to estimate room shielding requirements for this unit. The non-primary (scattered and leakage) ambient dose equivalent rates were measured with a Berthold LB-133 monitor (Berthold Technologies, Bad Wildbad, Germany). The latter ranges from 17 mSv h-1 at 0.25 m distance from the x-ray source to 0.1 mSv h-1 at 2.5 m. The necessary room shielding was then estimated following US and some European guidelines. The room shielding for all barriers considered was below 2 mmPb. The dose to a companion who, exceptionally, would stay with the patient during all treatment was estimated to be below 1 mSv if a leaded apron is used. In conclusion, Esteya shielding requirements are minimal.
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Affiliation(s)
- Blanca Ibanez-Rosello
- Radioprotection Department, La Fe University and Polytechnic Hospital, Valencia E-46026, Spain
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10
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Two years results of electronic brachytherapy for basal cell carcinoma. J Contemp Brachytherapy 2017; 9:251-255. [PMID: 28725249 PMCID: PMC5509982 DOI: 10.5114/jcb.2017.68191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 05/02/2017] [Indexed: 11/17/2022] Open
Abstract
Purpose The 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 methods This 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. Results Twenty-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. Conclusions This 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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Villalba SR, Perez-Calatayud MJ, Bautista JA, Carmona V, Celada F, Tormo A, García-Martinez T, Richart J, Ortega MS, Silla M, Ballester F, Perez-Calatayud J. Novel simple templates for reproducible positioning of skin applicators in brachytherapy. J Contemp Brachytherapy 2016; 8:344-8. [PMID: 27648089 PMCID: PMC5018523 DOI: 10.5114/jcb.2016.61713] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 07/18/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Esteya and Valencia surface applicators are designed to treat skin tumors using brachytherapy. In clinical practice, in order to avoid errors that may affect the treatment outcome, there are two issues that need to be carefully addressed. First, the selected applicator for the treatment should provide adequate margin for the target, and second, the applicator has to be precisely positioned before each treatment fraction. In this work, we describe the development and use of a new acrylic templates named Template La Fe-ITIC. They have been designed specifically to help the clinical user in the selection of the correct applicator, and to assist the medical staff in reproducing the positioning of the applicator. These templates are freely available upon request. MATERIAL AND METHODS Templates that were developed by University and Polytechnic Hospital La Fe (La Fe) and Hospital Clínica Benidorm (ITIC) in cooperation with Elekta, consist of a thin sheet made of transparent acrylic. For each applicator, a crosshair and two different circles are drawn on these templates: the inner one corresponds to the useful beam, while the outer one represents the external perimeter of the applicator. The outer circle contains slits that facilitate to draw a circle on the skin of the patient for exact positioning of the applicator. In addition, there are two perpendicular rulers to define the adequate margin. For each applicator size, a specific template was developed. RESULTS The templates have been used successfully in our institutions for more than 50 patients' brachytherapy treatments. They are currently being used for Esteya and Valencia applicators. CONCLUSIONS The template La Fe-ITIC is simple and practical. It improves both the set-up time and reproducibility. It helps to establish the adequate margins, an essential point in the clinical outcome.
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Affiliation(s)
| | | | | | - Vicente Carmona
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia
| | - Francisco Celada
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia
| | - Alejandro Tormo
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia
| | | | - José Richart
- Radiotherapy Department, Clínica Benidorm, Benidorm
| | | | - Magda Silla
- Dermatology Department, Clínica Benidorm, Benidorm
| | - Facundo Ballester
- Department of Atomic, Molecular, and Nuclear Physics, University of Valencia, Burjassot, Spain
| | - Jose Perez-Calatayud
- Radiotherapy Department, Clínica Benidorm, Benidorm; Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia
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12
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Fulkerson R. Comment on “Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry” [Med. Phys. 42
, 4954-4964 (2015)]. Med Phys 2016; 43:2005. [DOI: 10.1118/1.4942806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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13
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Candela-Juan C, Vijande J, García-Martínez T, Niatsetski Y, Nauta G, Schuurman J, Ouhib Z, Ballester F, Perez-Calatayud J. Response to “Comment on ‘Comparison and uncertainty evaluation of different calibration protocols and ionization chambers for low-energy surface brachytherapy dosimetry’ ” [Med. Phys. 42
, 4954-4964 (2015)]. Med Phys 2016; 43:2007. [DOI: 10.1118/1.4942807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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