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Oliver-Cañamás L, Vijande J, Candela-Juan C, Gimeno-Olmos J, Pujades-Claumarchirant MC, Rovira-Escutia JJ, Ballester F, Perez-Calatayud J. A User-Friendly System for Mailed Dosimetric Audits of 192Ir or 60Co HDR Brachytherapy Sources. Cancers (Basel) 2023; 15:cancers15092484. [PMID: 37173950 PMCID: PMC10177083 DOI: 10.3390/cancers15092484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES The main goal of this work is to design and characterize a user-friendly methodology to perform mailed dosimetric audits in high dose rate (HDR) brachytherapy for systems using either Iridium-192 (192Ir) or Cobalt-60 (60Co) sources. METHODS A solid phantom was designed and manufactured with four catheters and a central slot to place one dosimeter. Irradiations with an Elekta MicroSelectron V2 for 192Ir, and with a BEBIG Multisource for 60Co were performed for its characterization. For the dose measurements, nanoDots, a type of optically stimulated luminescent dosimeters (OSLDs), were characterized. Monte Carlo (MC) simulations were performed to evaluate the scatter conditions of the irradiation set-up and to study differences in the photon spectra of different 192Ir sources (Microselectron V2, Flexisource, BEBIG Ir2.A85-2 and Varisource VS2000) reaching the dosimeter in the irradiation set-up. RESULTS MC simulations indicate that the surface material on which the phantom is supported during the irradiations does not affect the absorbed dose in the nanoDot. Generally, differences below 5% were found in the photon spectra reaching the detector when comparing the Microselectron V2, the Flexisource and the BEBIG models. However, differences up to 20% are observed between the V2 and the Varisource VS2000 models. The calibration coefficients and the uncertainty in the dose measurement were evaluated. CONCLUSIONS The system described here is able to perform dosimetric audits in HDR brachytherapy for systems using either 192Ir or 60Co sources. No significant differences are observed between the photon spectra reaching the detector for the MicroSelectron V2, the Flexisource and the BEBIG 192Ir sources. For the Varisource VS2000, a higher uncertainty is considered in the dose measurement to allow for the nanoDot response.
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Affiliation(s)
- Laura Oliver-Cañamás
- Servei de Radiofísica i Protecció Radiològica, Consorci Hospitalari Provincial de Castelló (CHPC), 12002 Castelló de la Plana, Spain
| | - Javier Vijande
- Departamento de Física Atómica, Molecular y Nuclear, Universitat de Valencia (UV), 46100 Burjassot, 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), 46026 València, Spain
- Instituto de Física Corpuscular, Instituto de Física Corpuscular-IFIC (UV-CSIC), 46100 Burjassot, Spain
| | | | - Jose Gimeno-Olmos
- Unitat de Radiofísica, Servei d'Oncologia Radioteràpica, Hospital Universitari i Politècnic La Fe, 46026 València, Spain
| | | | - Juan J Rovira-Escutia
- Servei de Radiofísica i Protecció Radiològica, Consorci Hospital General Universitari de València, 46014 València, Spain
| | - Facundo Ballester
- Departamento de Física Atómica, Molecular y Nuclear, Universitat de Valencia (UV), 46100 Burjassot, 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), 46026 València, Spain
| | - 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), 46026 València, Spain
- Unitat de Radiofísica, Servei d'Oncologia Radioteràpica, Hospital Universitari i Politècnic La Fe, 46026 València, Spain
- Hospital Clínica Benidorm, 03501 Benidorm, Spain
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Otal A, Celada F, Chimeno J, Vijande J, Pellejero S, Perez-Calatayud MJ, Villafranca E, Fuentemilla N, Blazquez F, Rodriguez S, Perez-Calatayud J. Review on Treatment Planning Systems for Cervix Brachytherapy (Interventional Radiotherapy): Some Desirable and Convenient Practical Aspects to Be Implemented from Radiation Oncologist and Medical Physics Perspectives. Cancers (Basel) 2022; 14:cancers14143467. [PMID: 35884528 PMCID: PMC9318845 DOI: 10.3390/cancers14143467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/10/2022] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
Intracavitary brachytherapy (BT, Interventional Radiotherapy, IRT), plays an essential role in the curative intent of locally advanced cervical cancer, for which the conventional approach involves external beam radiotherapy with concurrent chemotherapy followed by BT. This work aims to review the different methodologies used by commercially available treatment planning systems (TPSs) in exclusive magnetic resonance imaging-based (MRI) cervix BT with interstitial component treatments. Practical aspects and improvements to be implemented into the TPSs are discussed. This review is based on the clinical expertise of a group of radiation oncologists and medical physicists and on interactive demos provided by the software manufacturers. The TPS versions considered include all the new tools currently in development for future commercial releases. The specialists from the supplier companies were asked to propose solutions to some of the challenges often encountered in a clinical environment through a questionnaire. The results include not only such answers but also comments by the authors that, in their opinion, could help solve the challenges covered in these questions. This study summarizes the possibilities offered nowadays by commercial TPSs, highlighting the absence of some useful tools that would notably improve the planning of MR-based interstitial component cervix brachytherapy.
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Affiliation(s)
- Antonio Otal
- Medical Physics Department, Hospital Universitari Arnau de Vilanova, 25198 Lleida, 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), 46010 Valencia, Spain; (J.V.); (J.P.-C.)
- Correspondence: ; Tel.: +34-973248100
| | - Francisco Celada
- Radiotherapy Department, La Fe Hospital, 46026 Valencia, Spain; (F.C.); (M.-J.P.-C.)
| | - Jose Chimeno
- Medical Physics Department, Hospital San Juan, 03550 Alicante, 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), 46010 Valencia, Spain; (J.V.); (J.P.-C.)
- Department of Atomic, Molecular and Nuclear Physics, University of Valencia, 46010 Valencia, Spain
- Instituto de Física Corpuscular, IFIC (UV-CSIC), 46010 Valencia, Spain
| | - Santiago Pellejero
- Radiation Oncology Department, Hospital Universitario de Navarra, 31008 Navarre, Spain; (S.P.); (E.V.); (N.F.)
| | | | - Elena Villafranca
- Radiation Oncology Department, Hospital Universitario de Navarra, 31008 Navarre, Spain; (S.P.); (E.V.); (N.F.)
| | - Naiara Fuentemilla
- Radiation Oncology Department, Hospital Universitario de Navarra, 31008 Navarre, Spain; (S.P.); (E.V.); (N.F.)
| | - Francisco Blazquez
- Radiotherapy Department, Hospital Clínica Benidorm, 03501 Alicante, Spain; (F.B.); (S.R.)
| | - Silvia Rodriguez
- Radiotherapy Department, Hospital Clínica Benidorm, 03501 Alicante, Spain; (F.B.); (S.R.)
| | - 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), 46010 Valencia, Spain; (J.V.); (J.P.-C.)
- Radiotherapy Department, La Fe Hospital, 46026 Valencia, Spain; (F.C.); (M.-J.P.-C.)
- Radiotherapy Department, Hospital Clínica Benidorm, 03501 Alicante, Spain; (F.B.); (S.R.)
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Tejedor-Aguilar N, Lliso F, Ruiz-Rodríguez JC, Gimeno-Olmos J, Carmona V, Bonaque J, Bautista JA, Perez-Calatayud J. Evaluation of intrafraction motion with an open immobilization mask for HyperArc treatment of multiple brain metastases. J Radiosurg SBRT 2022; 8:283-290. [PMID: 37416332 PMCID: PMC10322167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 07/08/2023]
Abstract
Purpose In the implementation of the use of EncompassTM partially open immobilization mask to perform SRS of multiple brain metastasis, the evaluation of patient's intrafraction motion (IM) is deemed convenient to verify that the margins applied to the GTV are able to ensure adequate dose coverage to each lesion. Methods IM was determined by comparing the pre- and post-treatment CBCT images with respect to the simulation CT for a total of 23 fractions. The dosimetric impact on GTV coverage due to translational errors in patient positioning and rotational uncertainties of LINAC's performance was also evaluated. Results The absolute magnitude of IM was less than 1 mm in all cases. The dosimetric difference on GTV coverage due to patient's IM was inferior to 5%. There was not found any significant correlation between the dosimetric impact of rotational uncertainties with the distance to the isocenter. Conclusion The margins applied to the GTV are adequate when using EncompassTM immobilization device.
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Affiliation(s)
- Natalia Tejedor-Aguilar
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Françoise Lliso
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Juan C. Ruiz-Rodríguez
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Jose Gimeno-Olmos
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Vicente Carmona
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Jorge Bonaque
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Juan A. Bautista
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
| | - Jose Perez-Calatayud
- Radiation Oncology Department, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell, 106, 46026, Valencia, Spain
- Radiation Oncology Department, Clinica Benidorm, Av. Alfonso Puchades, 8, 03501 Alicante, Spain
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Vijande J, Carlsson Tedgren Å, Ballester F, Baltas D, Papagiannis P, Rivard MJ, Siebert FA, De Werd L, Perez-Calatayud J. Source strength determination in iridium-192 and cobalt-60 brachytherapy: A European survey on the level of agreement between clinical measurements and manufacturer certificates. Phys Imaging Radiat Oncol 2021; 19:108-111. [PMID: 34401536 PMCID: PMC8348214 DOI: 10.1016/j.phro.2021.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 07/08/2021] [Accepted: 07/14/2021] [Indexed: 11/28/2022]
Abstract
Background and purpose Brachytherapy treatment outcomes depend on the accuracy of the delivered dose distribution, which is proportional to the reference air-kerma rate (RAKR). Current societal recommendations require the medical physicist to compare the measured RAKR values to the manufacturer source calibration certificate. The purpose of this work was to report agreement observed in current clinical practice in the European Union. Materials and methods A European survey was performed for high- and pulsed-dose-rate (HDR and PDR) high-energy sources (192Ir and 60Co), to quantify observed RAKR differences. Medical physicists at eighteen hospitals from eight European countries were contacted, providing 1,032 data points from 2001 to 2020. Results Over the survey period, 77% of the 192Ir measurements used a well chamber instead of the older Krieger phantom method. Mean differences with the manufacturer calibration certificate were 0.01% ± 1.15% for 192Ir and –0.1% ± 1.3% for 60Co. Over 95% of RAKR measurements in the clinic were within 3% of the manufacturer calibration certificate. Conclusions This study showed that the agreement level was generally better than that reflected in prior societal recommendations positing 5%. Future recommendations on high-energy HDR and PDR source calibrations in the clinic may consider tightened agreements levels.
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Affiliation(s)
- Javier Vijande
- Departamento de Física Atómica, Molecular y Nuclear, Universitat de Valencia (UV), Burjassot, 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), Valencia, Spain.,Instituto de Física Corpuscular, IFIC (UV-CSIC), Burjassot, Spain
| | - Åsa Carlsson Tedgren
- Radiation Physics, Department of Medicine, Health and Caring Sciences (HMV), Linköping University, Linköping, Sweden.,Department of Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden.,Department of Oncology Pathology, the Karolinska Institute, Stockholm, Sweden
| | - Facundo Ballester
- Departamento de Física Atómica, Molecular y Nuclear, Universitat de Valencia (UV), Burjassot, 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), Valencia, Spain
| | - Dimos Baltas
- Division of Medical Physics, Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Panagiotis Papagiannis
- Medical Physics Laboratory, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens, Greece
| | - Mark J Rivard
- Department of Radiation Oncology, Alpert Medical School of Brown University, Providence, USA
| | - Frank-André Siebert
- Clinic of Radiotherapy, UniversityHospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Larry De Werd
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States of America
| | - 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), Valencia, Spain.,Radiotherapy Department, La Fe Hospital, Valencia, and Clinica Benidorm, Alicante, Spain
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Chimeno J, Fuentemilla N, Monasor P, Celada F, Villafranca E, Rodriguez S, Perez-Calatayud M, Pellejero S, Perez-Calatayud J. PO-0206 A dosimetric index to assess cervix brachytherapy implants: Dovix. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vijande J, Carlsson Tedgren Å, Ballester F, Baltas D, Papagiannis P, Rivard M, Siebert F, DeWerd L, Perez-Calatayud J. OC-0131 WP21 BRAPHYQS survey of differences in 192Ir and 60Co brachytherapy RAKR determinations. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Perez-Calatayud MJ, Conde-Moreno AJ, Celada-Álvarez FJ, Rubio C, López-Campos F, Navarro-Martin A, Arribas L, Santos M, Lopez-Torrecilla J, Perez-Calatayud J. SEOR SBRT-SG survey on SRS/SBRT dose prescription criteria in Spain. Clin Transl Oncol 2021; 23:1794-1800. [PMID: 33730312 DOI: 10.1007/s12094-021-02583-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 03/04/2021] [Indexed: 11/25/2022]
Abstract
AIM Stereotactic body radiotherapy (SBRT) and stereotactic radiosurgery (SRS) are essential tools in radiation oncology. In Spain, the use of these techniques continues to grow as older linear accelerators (linacs) are replaced with modern equipment. However, little is known about inter-centre variability in prescription and dose heterogeneity limits. Consequently, the SBRT-Spanish Task Group (SBRT-SG) of the Spanish Society of Radiation Oncology (SEOR) has undertaken an initiative to assess prescription and homogeneity in SRS/SBRT treatment. In the present study, we surveyed radiation oncology (RO) departments to obtain a realistic overview of prescription methods used for SBRT and SRS treatment in Spain. METHODS A brief survey was developed and sent to 34 RO departments in Spain, mostly those who are members of the SEOR SBRT-SG. The survey contained seven questions about the specific prescription mode, dose distribution heterogeneity limits, prescription strategies according to SRS/SBRT type, and the use of IMRT-VMAT (Intensity Modulated Radiation Therapy-Volumetric Modulated Arc Therapy). RESULTS Responses were received from 29 centres. Most centres (59%) used the prescription criteria D95% ≥ 100%. Accepted dose heterogeneity was wide, ranging from 107 to 200%. Most centres used IMRT-VMAT (93%). CONCLUSIONS This survey about SRS/SBRT prescription and dose heterogeneity has evidenced substantial inter-centre variability in prescription criteria, particularly for intended and accepted dose heterogeneity. These differences could potentially influence the mean planning target volume dose and its correlation with treatment outcomes. The findings presented here will be used by the SEOR SBRT-SG to develop recommendations for SRS/SBRT dose prescription and heterogeneity.
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Affiliation(s)
- M J Perez-Calatayud
- Radiation Oncology Department, Fundacion Instituto Valenciano de Oncologia, C/Beltrán Báguena 8, 46009, Valencia, Spain.
| | | | | | - C Rubio
- Radiation Oncology Department, Hospital HM Sanchinarro, HM Hospitales, Madrid, Spain
| | - F López-Campos
- Radiation Oncology Department, Hospital Ramon Y Cajal, Madrid, Spain
| | - A Navarro-Martin
- Radiation Oncology Department, Hospital Duran I Reynals, Instituto Catalan de Oncología, Barcelona, Spain
| | - L Arribas
- Radiation Oncology Department, Fundacion Instituto Valenciano de Oncologia, C/Beltrán Báguena 8, 46009, Valencia, Spain
| | - M Santos
- Radiation Oncology Department, Clinica Benidorm, Alicante, Spain
| | | | - J Perez-Calatayud
- Radiation Oncology Department, Hospital La Fe, Valencia, Spain.,Radiation Oncology Department, Clinica Benidorm, Alicante, 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] [What about the content of this article? (0)] [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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Pons-Llanas O, Burgos-Burgos J, Roldan-Ortega S, Conde-Moreno A, Celada-Alvarez F, Ruiz-Martinez JC, Lliso-Valverde F, Tormo-Micó A, Perez-Calatayud J, López-Torrecilla J. Salvage I-125 brachytherapy for locally-recurrent prostate cancer after radiotherapy. Rep Pract Oncol Radiother 2020; 25:754-759. [PMID: 32684865 DOI: 10.1016/j.rpor.2020.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/15/2020] [Accepted: 06/23/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose Retrospective, single-institution analysis of clinical outcomes and treatment-related toxicity in patients treated with salvage I-125 low-dose rate (LDR) brachytherapy (BT) for locally-recurrent prostate cancer after radiotherapy. Materials and methods Between 2008 and 2018, 30 patients with biopsy-confirmed prostate cancer recurrence underwent salvage treatment with I-125 LDR-BT. Of these 30 patients, 14 were previously treated with primary external beam radiotherapy (EBRT; median dose, 73 Gy) and 16 with primary I-125 LDR-BT (145 Gy and 160 Gy in 14 and 2 cases, respectively). At seed implantation, the mean age was 75.8 years, with a median Gleason score of 7 and pre-salvage PSA of <10 ng/mL. Six patients received androgen deprivation therapy for six months after relapse diagnosis. The prescribed salvage I-125 BT dose to the gland was 120-130 Gy, with dose restrictions of Dmax <135% (urethra) and <100% (rectum). Toxicity was evaluated according to the CTCAE scale (v4.0). Results At a median follow-up of 45 months, the biochemical recurrence-free survival rates at 1, 3 and 5 years were 86.7%, 56.7% and 53.3%, respectively. Overall survival at 5 years was 87%. On the multivariate analysis, two variables were significant predictors of recurrence: PSA at relapse and nadir PSA post-salvage. Grade 3 genitourinary toxicity was observed in 5 patients (radiation-induced cystitis in 3 cases and urethral stenosis in 2) and G3 gastrointestinal toxicity in 3 patients (rectal bleeding). Conclusion Salvage therapy with I-125 brachytherapy is a safe and effective treatment option for locally-recurrent prostate cancer in previously-irradiated patients. High pre-salvage PSA and post-salvage nadir PSA values were significantly associated with a worse disease control after salvage I-125 LDR-BT. In well-selected patients, I-125 LDR-BT is comparable to other salvage therapies in terms of disease control and toxicity. However, more research is needed to determine the optimal management of locally-recurrent prostate cancer.
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Affiliation(s)
- O Pons-Llanas
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - J Burgos-Burgos
- Radiotherapy Department, Hospital, Las Palmas de Gran Canaria, Spain
| | - S Roldan-Ortega
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - A Conde-Moreno
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - F Celada-Alvarez
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - J C Ruiz-Martinez
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - F Lliso-Valverde
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - A Tormo-Micó
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
| | - J Perez-Calatayud
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia Spain
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Pons-Llanas O, Collado-Ballesteros E, Roldan-Ortega S, Conde-Moreno A, Celada-Alvarez F, Martínez-Arcelus F, Pérez-Calatayud MJ, Carmona-Meseguer V, Gimeno-Olmos J, Forner-Ferrer V, Tormo-Micó A, Perez-Calatayud J, López-Torrecilla J. Impact of real-time, dose-escalated permanent seed implant brachytherapy in intermediate-risk prostate cancer. Rep Pract Oncol Radiother 2020; 25:463-469. [PMID: 32494221 DOI: 10.1016/j.rpor.2020.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/21/2020] [Accepted: 04/20/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To retrospectively evaluate biochemical control and toxicity in patients who underwent 125I seed brachytherapy (BT) for intermediate-risk prostate cancer (PCa). Materials and Methods Between January 2004-December 2014, 395 patients with intermediate-risk PCa underwent 125I BT. Of these, 117 underwent preoperative planning (PP; 145 Gy) and 278 real-time intraoperative preplanning (IoP; 160 Gy). All patients were followed for ≥ 6 months (> 5 years in 48% of patients and > 7 years in 13%). Median follow-up was 59 months. Results Biochemical relapse-free survival (BRFS) rates at 5 and 8 years were, respectively, 91.7% and 82.1%. By treatment group, the corresponding BRFS rates were 93.5% and 90% for IoP and 89% and 76.8% for PP. The maximum dose to the urethra remained unchanged (217 Gy) despite the dose escalation (from 145 to 160 Gy), without any significant increase in treatment-related toxicity (p = 0.13). Overall toxicity outcomes in the series were excellent, with only 3 cases (0.76%) of grade 3 genitourinary toxicity. Conclusion The real-time intraoperative planning technique at 160 Gy yields better biochemical controls than the preoperative planning technique at 145 Gy. Dose escalation did not increase urinary toxicity. The excellent results obtained with the IoP BT technique support its use as the first treatment option in this patient population.
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Affiliation(s)
- O Pons-Llanas
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - E Collado-Ballesteros
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - S Roldan-Ortega
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - A Conde-Moreno
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - F Celada-Alvarez
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - F Martínez-Arcelus
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - M J Pérez-Calatayud
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - V Carmona-Meseguer
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - J Gimeno-Olmos
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - V Forner-Ferrer
- Biostatistics Unity, Medical Research Institute La Fe University and Polytechnic Hospital, Valencia, Spain
| | - A Tormo-Micó
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
| | - J Perez-Calatayud
- Radiotherapy Department, La Fe University and Polytechnic Hospital, Avenida Abril Martorell, 106, 46026 Valencia Spain
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11
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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12
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Valdés C, Ballester F, Vijande J, Perez-Calatayud J. EP-1749 Relation between depth dose and HVL for electronic brachytherapy systems: a Monte Carlo study. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32169-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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Perez-Calatayud J, Ballester F, Carlsson Tedgren Å, Rijnders A, Rivard MJ, Andrássy M, Niatsetski Y, Schneider T, Siebert FA. GEC-ESTRO ACROP recommendations on calibration and traceability of LE-LDR photon-emitting brachytherapy sources at the hospital level. Radiother Oncol 2019; 135:120-129. [PMID: 31015157 DOI: 10.1016/j.radonc.2019.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/09/2019] [Indexed: 11/25/2022]
Abstract
Prostate brachytherapy treatment using permanent implantation of low-energy (LE) low-dose rate (LDR) sources is successfully and widely applied in Europe. In addition, seeds are used in other tumour sites, such as ophthalmic tumours, implanted temporarily. The calibration issues for LE-LDR photon emitting sources are specific and different from other sources used in brachytherapy. In this report, the BRAPHYQS (BRAchytherapy PHYsics Quality assurance System) working group of GEC-ESTRO, has developed the present recommendations to assure harmonized and high-quality seed calibration in European clinics. There are practical aspects for which a clarification/procedure is needed, including aspects not specifically accounted for in currently existing AAPM and ESTRO societal recommendations. The aim of this report has been to provide a European wide standard in LE-LDR source calibration at end-user level, in order to keep brachytherapy treatments with high safety and quality levels. The recommendations herein reflect the guidance to the ESTRO brachytherapy users and describe the procedures in a clinic or hospital to ensure the correct calibration of LE-LDR seeds.
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Affiliation(s)
- Jose Perez-Calatayud
- Radiotherapy Department, University and Polytechnic La Fe Hospital, Valencia, Spain; IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain.
| | - Facundo Ballester
- IRIMED Joint Research Unit (IIS La Fe - UV), Valencia, Spain; Departmento of Atomic, Molecular and Nuclear Physics, University of Valencia, Valencia, Spain
| | - Åsa Carlsson Tedgren
- Radiation Physics, Department of Medicine and Health (IMH), Linköping University, Linköping, Sweden; Section of Radiotherapy Physics and Engineering, Medical Radiation Physics and Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology Pathology, Karolinska Institute, Stockholm, Sweden
| | - Alex Rijnders
- Department of Radiotherapy, Europe Hospitals, Brussels, Belgium
| | - Mark J Rivard
- Department of Radiation Oncology, Alpert Medical School of Brown University, Providence, USA
| | | | - Yury Niatsetski
- R&D Elekta Brachytherapy Waardgelder 1, Veenendaal, Netherlands
| | - Thorsten Schneider
- Physikalisch-Technische Bundesanstalt (PTB), Department of Radiation Protection Dosimetry, Braunschweig, Germany
| | - Frank-André Siebert
- UK S-H, Campus Kiel, Klinik für Strahlentherapie (Radioonkologie), Kiel, Germany
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14
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García-Cases F, Perez-Calatayud J, Ballester F, Vijande J, Granero D. Peripheral dose around a mobile linac for intraoperative radiotherapy: radiation protection aspects. J Radiol Prot 2018; 38:1393-1411. [PMID: 30277221 DOI: 10.1088/1361-6498/aae5a0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this work is to analyse the scattered radiation produced by the mobile accelerator Mobetron 1000. To do so, detailed Monte Carlo simulations using two different codes, Penelope2008 and Geant4, were performed. Measurements were also done. To quantify the attenuation due to the internal structures, present in the accelerator head, on the scattered radiation produced, some of the main structural shielding in the Mobetron 1000 has been incorporated into the geometry simulation. Results are compared with measurements. Some discrepancies between the calculated and measured dose values were found. These differences can be traced back to the importance of the radiation component due to low energy scattered electrons. This encouraged us to perform additional calculations to separate the role played by this component. Ambient dose equivalent, H*(10), outside of the operating room (OR) has been evaluated using Geant4. H*(10) has been measured inside and outside the OR, being its values compatible with those reported in the literature once the low energy electron component is removed. With respect to the role played by neutrons, estimations of neutron H*(10) using Geant4 together with H*(10) measurements has been performed for the case of the 12 MeV electron beam. The values obtained agree with the experimental values existing in the literature, being much smaller than those registered in conventional accelerators. This study is a useful tool for the clinical user to investigate the radiation protection issues arising with the use of these accelerators in ORs without structural shielding. These results will also enable to better fix the maximum number of treatments that could be performed while insuring adequate radiological protection of workers and public in the hospital.
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Affiliation(s)
- F García-Cases
- Servicio de Radiofísica y Protección Radiológica, Hospital Universitario San Juan de Alicante, San Juan de Alicante, Spain
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15
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Perez-Calatayud M, Ibanez-Rosello B, Farga Albiol D, Rodriguez Pla M, Martin Garcia E, Carmona V, Gimeno-Olmos J, Celada Álvarez F, Bernisz Diaz M, Perez-Calatayud J, Tormo Micó A, Menéndez-López A. EP-1220: Use of VMAT in Linac-SRS Vestibular Schwannomas. Dosimetric report of 34 cases in our Institution. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31530-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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17
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Bonaque-Alandi J, Bonaque-Alandi J, Bautista-Ballesteros J, Bautista-Ballesteros J, Ibanez-Rosello B, Adria-Mora M, Gimeno-Olmos J, Carmona-Meseguer V, Lliso-Valverde F, Perez-Calatayud J. EP-2022: Interlay effect in SBRT VMAT lung FFF treatments using ionization liquid chambers array detector. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32331-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Guinot JL, Rembielak A, Perez-Calatayud J, Rodríguez-Villalba S, Skowronek J, Tagliaferri L, Guix B, Gonzalez-Perez V, Valentini V, Kovacs G. GEC-ESTRO ACROP recommendations in skin brachytherapy. Radiother Oncol 2018; 126:377-385. [PMID: 29455924 DOI: 10.1016/j.radonc.2018.01.013] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/18/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE The aim of this publication is to compile available literature data and expert experience regarding skin brachytherapy (BT) in order to produce general recommendations on behalf of the GEC-ESTRO Group. METHODS We have done an exhaustive review of published articles to look for general recommendations. RESULTS Randomized controlled trials, systemic reviews and meta-analysis are lacking in literature and there is wide variety of prescription techniques successfully used across the radiotherapy centers. BT can be delivered as superficial application (also called contact BT or plesiotherapy) or as interstitial for tumours thicker than 5 mm within any surface, including very irregular. In selected cases, particularly in tumours located within curved surfaces, BT can be advantageous modality from dosimetric and planning point of view when compared to external beam radiotherapy. The general rule in skin BT is that the smaller the target volume, the highest dose per fraction and the shortest overall length of treatment can be used. CONCLUSION Skin cancer incidence is rising worldwide. BT offers an effective non-invasive or minimally invasive and relative short treatment that particularly appeals to elder and frail population.
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Affiliation(s)
- Jose L Guinot
- Department of Radiation Oncology, Foundation Instituto Valenciano de Oncologia (I.V.O.), Valencia, Spain
| | - Agata Rembielak
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Jose Perez-Calatayud
- Department of Radiation Oncology, La Fe University Hospital-IRIMED, Valencia, Spain
| | | | - Janusz Skowronek
- Brachytherapy Department, Greater Poland Cancer Centre, Poznań, Poland; Electroradiology Department, Poznan University of Medical Sciences, Poland
| | - Luca Tagliaferri
- Polo Scienze Oncologiche ed Ematologiche, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - Benjamin Guix
- Department of Radiation Oncology, Foundation IMOR, Barcelona, Spain
| | - Victor Gonzalez-Perez
- Department of Radiation Physics, Foundation Instituto Valenciano de Oncologia (I.V.O.), Valencia, Spain
| | - Vincenzo Valentini
- Polo Scienze Oncologiche ed Ematologiche, Istituto di Radiologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Rome, Italy
| | - György Kovacs
- Interdisciplinary Brachytherapy Unit, UKSH CL, Lübeck, Germany
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19
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Rodríguez S, Arenas M, Gutierrez C, Richart J, Perez-Calatayud J, Celada F, Santos M, Rovirosa A. Recommendations of the Spanish brachytherapy group (GEB) of Spanish Society of Radiation Oncology (SEOR) and the Spanish Society of Medical Physics (SEFM) for high-dose rate (HDR) non melanoma skin cancer brachytherapy. Clin Transl Oncol 2017; 20:431-442. [PMID: 28808925 DOI: 10.1007/s12094-017-1733-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 07/28/2017] [Indexed: 12/13/2022]
Abstract
Clinical indications of brachytherapy in non-melanoma skin cancers, description of applicators and dosimetry recommendations are described based on the literature review, clinical practice and experience of Spanish Group of Brachytherapy and Spanish Society of Medical Physics reported in the XIV Annual Consensus Meeting on Non Melanoma Skin Cancer Brachytherapy held in Benidorm, Alicante (Spain) on October 21st, 2016. All the recommendations for which consensus was achieved are highlighted in blue. Regular and small surfaces may be treated with Leipzig, Valencia, flap applicators or electronic brachytherapy (EBT). For irregular surfaces, customized molds or interstitial implants should be employed. The dose is prescribed at a maximum depth of 3-4 mm of the clinical target volume/planning target volume (CTV/PTV) in all cases except in flaps or molds in which 5 mm is appropriate. Interstitial brachytherapy should be used for CTV/PTV >5 mm. Different total doses and fraction sizes are used with very similar clinical and toxicity results. Hypofractionation is very useful twice or 3 times a week, being comfortable for patients and practical for Radiotherapy Departments. In interstitial brachytherapy 2 fractions twice a day are applied.
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Affiliation(s)
- S Rodríguez
- Radiation Oncology Department, Hospital Clínica Benidorm, Av. Alfonso Puchades 8, 30501, Benidorm, Alicante, Spain.
| | - M Arenas
- Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - C Gutierrez
- Radiation Oncology Department, Institut Català d'Oncologia, Hospitalet de Llobregat, Catalonia, Spain
| | - J Richart
- Radiation Oncology Department, Hospital Clínica Benidorm, Av. Alfonso Puchades 8, 30501, Benidorm, Alicante, Spain
| | - J Perez-Calatayud
- Radiation Oncology Department, Hospital La Fe-IRIMED, Valencia, Spain
| | - F Celada
- Radiation Oncology Department, Hospital La Fe-IRIMED, Valencia, Spain
| | - M Santos
- Radiation Oncology Department, Hospital Clínica Benidorm, Av. Alfonso Puchades 8, 30501, Benidorm, Alicante, Spain
| | - A Rovirosa
- Radiation Oncology Department, ICMHO, Hospital Clínic I Universitari, Barcelona, Spain
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20
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Ibanez-Rosello B, Bautista JA, Bonaque J, Perez-Calatayud J, Gonzalez-Sanchis A, Lopez-Torrecilla J, Brualla-Gonzalez L, Garcia-Hernandez T, Vicedo-Gonzalez A, Granero D, Serrano A, Borderia B, Solera C, Rosello J. Failure modes and effects analysis of total skin electron irradiation technique. Clin Transl Oncol 2017; 20:330-365. [PMID: 28779421 DOI: 10.1007/s12094-017-1721-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 07/24/2017] [Indexed: 11/26/2022]
Abstract
PURPOSE Total skin electron irradiation (TSEI) is a radiotherapy technique which consists of an homogeneous body surface irradiation by electrons. This treatment requires very strict technical and dosimetric conditions, requiring the implementation of multiple controls. Recently, the Task Group 100 report of the AAPM has recommended adapting the quality assurance program of the facility to the risks of their processes. MATERIALS AND METHODS A multidisciplinary team evaluated the potential failure modes (FMs) of every process step, regardless of the management tools applied in the installation. For every FM, occurrence (O), severity (S) and detectability (D) by consensus was evaluated, which resulted in the risk priority number (RPN), which permitted the ranking of the FMs. Subsequently, all the management tools used, related to the TSEI process, were examined and the FMs were reevaluated, to analyze the effectiveness of these tools and to propose new management tools to cover the greater risk FMs. RESULTS 361 FMs were identified, 103 of which had RPN ≥80, initially, and 41 had S ≥ 8. Taking this into account the quality management tools FMs were reevaluated and only 30 FMs had RPN ≥80. The study of these 30 FMs emphasized that the FMs that involved greater risk were related to the diffuser screen placement and the patient's position during treatment. CONCLUSIONS The quality assurance program of the facility has been adapted to the risk of this treatment process, following the guidelines proposed by the TG-100. However, clinical experience continually reveals new FMs, so the need for periodic risk analysis is required.
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Affiliation(s)
- B Ibanez-Rosello
- Radiation Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain.
| | - J A Bautista
- Radiation Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - J Bonaque
- Radiation Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, Spain
| | - J Perez-Calatayud
- Radiation Oncology Department, La Fe University and Polytechnic Hospital, Av. Fernando Abril Martorell 106, 46026, Valencia, 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), 46026, Valencia, Spain
| | - A Gonzalez-Sanchis
- Radiation Oncology Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - J Lopez-Torrecilla
- Radiation Oncology Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - L Brualla-Gonzalez
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - T Garcia-Hernandez
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - A Vicedo-Gonzalez
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - D Granero
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - A Serrano
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - B Borderia
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - C Solera
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
| | - J Rosello
- Medical Physics Department, ERESA, Hospital General Universitario, 46014, Valencia, Spain
- Physiology Department, University of Valencia, 46010, Valencia, Spain
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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. J Radiol Prot 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Villalba SR, Palacin AO, Sancho JR, Perez-Calatayud J, Ortega MS. Acute Toxicity in Low Risk Prostate Patients: Low Dose Rate vs High Dose Rate Brachytherapy Monotherapy. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Otal A, Richart J, Domingo C, Rodriguez S, Rodriguez-Meijide P, Fotina I, Santos M, Perez-Calatayud J. EP-1795: A novel MRI markers system in applicator reconstruction for brachytherapy. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32157-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chicas-Sett R, Farga D, Perez-Calatayud MJ, Celada F, Roldan S, Fornes-Ferrer V, Ibanez-Rosello B, Tormo A, Benlloch JM, Perez-Calatayud J. High-dose-rate brachytherapy boost for prostate cancer: Analysis of dose-volume histogram parameters for predicting late rectal toxicity. Brachytherapy 2017; 16:511-517. [DOI: 10.1016/j.brachy.2017.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/01/2017] [Accepted: 03/03/2017] [Indexed: 11/30/2022]
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Chicas-Sett R, Celada F, Burgos J, Farga D, Perez-Calatayud M, Roldan S, Collado E, Ibañez B, Perez-Calatayud J, Tormo A. PO-0726: Dose escalation with HDR brachytherapy for intermediate- and high-risk prostate cancer. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31163-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Villalba SR, Palacin AO, Sancho JR, Perez-Calatayud J, Ortega MS. Systematic Checking of the Location of Brachytherapy Applicators in the Treatment of the Vaginal Cuff: Necesity to Guarantee Treatment Success. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Villalba SR, Sancho JR, Palacin AO, Perez-Calatayud J, Ortega MS. Single Radiation Therapy (EBRT) vs Combined Treatment (EBRT + BT) in Intermediate and High Risk Prostate Cancer. Are We Sure That Exclusive EBRT Is a Valid Approach Treatment Mode? Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Chicas-Sett R, Farga-Albiol D, Perez-Calatayud MJ, Celada F, Roldan S, Burgos J, Ibanez-Rosello B, Benlloch JM, Perez-Calatayud J, Tormo A. Assessing the Relationship Between Dose-Volume Histogram Parameters and Late Rectal Toxicity in HDR Brachytherapy for Prostate Cancer. Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Villalba SR, Palacin AO, Sancho JR, Perez-Calatayud J, Ortega MS, Domingo C. Twice vs Single Applications in High Dose Rate Brachytherapy (HDR) Boost. Same Results in High Risk Prostate Cancer Patients? Brachytherapy 2017. [DOI: 10.1016/j.brachy.2017.04.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ibanez-Rosello B, Bautista-Ballesteros J, Bonaque J, Perez-Calatayud J, Gonzalez-Sanchis A, Lopez-Torrecilla J, Brualla-Gonzalez L, Garcia- Hernandez M, Vicedo-Gonzalez A, Granero D, Serrano A, Borderia B, Rosello J. EP-1744: Failure modes and effects analysis of Total Skin Electron Irradiation (TSEI) technique. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32107-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Lliso F, Carmona V, Gimeno J, Ibañez B, Bautista J, Bonaque J, Chicas R, Burgos J, Perez-Calatayud J. EP-1538: VMAT craniospinal radiotherapy, planning strategy and results in twenty pediatric and adult patients. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31973-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) 60Co sources along a transfer tube as compared to 192Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom. The movement of the source was included by displacing their positions along the connecting tube from z = -75 cm to z = +75 cm and combining them. Since modern afterloaders like Flexitron (Elekta) or Saginova (BEBIG GmbH) are able to use equally 192Ir and 60Co sources, it was assumed that both sources are displaced with equal speed. Typical HDR source activity content values were provided by the manufacturer. 2D distributions were obtained with type-A uncertainties (k = 2) less than 0.01%. From those, the air-kerma ratio 60Co/192Ir was evaluated weighted by their corresponding typical activities. It was found that it varies slowly with distance (less than 10% variation at 75 cm) but strongly in time due to the shorter half-life of the 192Ir (73.83 d). The maximum ratio is located close to the tube. It reaches a value of 0.57 when the typical activity of the sources at the time when they were installed by the vendor was used. Such ratio increases up to 1.28 at the end of the recommended working life (90 d) of the 192Ir source. 60Co/192Ir air-kerma ratios are almost constant (0.51-0.57) in the vicinity of the source-tube with recent installed sources. Nevertheless, air-kerma ratios increase rapidly (1.15-1.29) whenever the 192Ir is approaching the end of its life. In case of a medical event requiring the medical staff to access the treatment room, these ratios indicate that the dosimetric impact on the medical team will be lower, with a few exceptions, in the case of 60Co-based HDR brachytherapy as compared to 192Ir-based one when typical air-kerma strength values are considered.
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Affiliation(s)
- Vicent Giménez-Alventosa
- Department of Atomic, Molecular and Nuclear Physics, University of Valencia, 46100 Burjassot, Spain
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Trompier F, Baumann M, Barrios L, Gregoire E, Abend M, Ainsbury E, Barnard S, Barquinero JF, Bautista JA, Brzozowska B, Perez-Calatayud J, De Angelis C, Domínguez I, Hadjidekova V, Kulka U, Mateos JC, Meschini R, Monteiro Gil O, Moquet J, Oestreicher U, Montoro Pastor A, Quintens R, Sebastià N, Sommer S, Stoyanov O, Thierens H, Terzoudi G, Villaescusa JI, Vral A, Wojcik A, Zafiropoulos D, Roy L. Investigation of the influence of calibration practices on cytogenetic laboratory performance for dose estimation. Int J Radiat Biol 2016; 93:118-126. [DOI: 10.1080/09553002.2016.1213455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- François Trompier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | - Marion Baumann
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | | | - Eric Gregoire
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
| | - Michael Abend
- Bundeswehr Institut für Radiologie in verbindung mit der Universtität Ulm, Germany
| | - Elizabeth Ainsbury
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | - Stephen Barnard
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | | | | | - Beata Brzozowska
- Stockholm University, Department of Molecular Biosciences, Stockholm, Sweden
| | | | | | | | | | - Ulrike Kulka
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Neuherberg, Germany
| | | | | | - Octávia Monteiro Gil
- Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela-LRS, Portugal
| | - Jayne Moquet
- Public Health England Centre for Radiation, Chemical and Environmental Hazards (PHE), Chilton, UK
| | - Ursula Oestreicher
- Bundesamt fuer Strahlenschutz, Department Radiation Protection and Health, Neuherberg, Germany
| | | | - Roel Quintens
- Belgian Nuclear Research Centre (SCK-CEN), Mol, Belgium
| | | | | | | | - Hubert Thierens
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Georgia Terzoudi
- National Centre for Scientific Research “Demokritos”, Health Physics, Radiobiology & Cytogenetics, Athens, Greece
| | | | - Anne Vral
- Faculty of Medicine and Health Sciences, Ghent University, Gent, Belgium
| | - Andrzej Wojcik
- Stockholm University, Department of Molecular Biosciences, Stockholm, Sweden
| | | | - Laurence Roy
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-roses, France
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Gimenez-Alventosa V, Vijande J, Ballester F, Perez-Calatayud J. SU-F-T-13: Transit Dose Comparisons for Co-60 and Ir-192 HDR Sources. Med Phys 2016. [DOI: 10.1118/1.4956147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Richart J, Otal A, Rodriguez S, Santos M, Perez-Calatayud J. SU-F-T-47: MRI T2 Exclusive Based Planning Using the Endocavitary/interstitial Gynecological Benidorm Applicator: A Proposed TPS Library and Preplan Efficient Methodology. Med Phys 2016. [DOI: 10.1118/1.4956182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Granero D, Candela-Juan C, Vijande J, Ballester F, Perez-Calatayud J, Jacob D, Mourtada F. SU-F-T-63: Dosimetric Relevance of the Valencia and Leipzig HDR Applicators Plastic Cap. Med Phys 2016. [DOI: 10.1118/1.4956469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ibanez-Rosello B, Bautista-Ballesteros J, Bonaque J, Perez-Calatayud J, Gonzalez-Sanchis A, Lopez-Torrecilla J, Brualla-Gonzalez L, Garcia-Hernandez T, Vicedo-Gonzalez A, Granero D, Serrano A, Borderia B, Solera C, Rosello J. SU-F-T-248: FMEA Risk Analysis Implementation (AAPM TG-100) in Total Skin Electron Irradiation Technique. Med Phys 2016. [DOI: 10.1118/1.4956471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Hueso-Gonzalez F, Vijande J, Ballester F, Perez-Calatayud J, Siebert F. SU-G-201-02: Application of RayStretch in Clinical Cases: A Calculation for Heterogeneity Corrections in LDR Permanent I-125 Prostate Brachytherapy. Med Phys 2016. [DOI: 10.1118/1.4956875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ibanez-Rosello B, Bautista-Ballesteros J, Bonaque J, Lliso F, Carmona V, Gimeno J, Ouhib Z, Perez-Calatayud J. WE-H-BRC-01: Failure Mode and Effects Analysis of Skin Electronic Brachytherapy Using Esteya Unit. Med Phys 2016. [DOI: 10.1118/1.4957979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Bonaque J, Bautista-Ballesteros J, Ibanez-Rosello B, Lliso F, Carmona V, Gimeno J, Perez-Calatayud J. SU-F-J-40: Evaluation of Sensitivity of the Automatic Matching Between Cone-Beam CT Image and Simulation CT Image in TrueBeam 2.0 Imaging System 6DoF Considering Different Uncertainty Sources. Med Phys 2016. [DOI: 10.1118/1.4955948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Quast U, Kaulich TW, Álvarez-Romero JT, Carlsson Tedgren S, Enger SA, Medich DC, Mourtada F, Perez-Calatayud J, Rivard MJ, Zakaria GA. A brachytherapy photon radiation quality index Q(BT) for probe-type dosimetry. Phys Med 2016; 32:741-8. [PMID: 27237583 DOI: 10.1016/j.ejmp.2016.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 02/15/2016] [Accepted: 03/16/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION In photon brachytherapy (BT), experimental dosimetry is needed to verify treatment plans if planning algorithms neglect varying attenuation, absorption or scattering conditions. The detector's response is energy dependent, including the detector material to water dose ratio and the intrinsic mechanisms. The local mean photon energy E¯(r) must be known or another equivalent energy quality parameter used. We propose the brachytherapy photon radiation quality indexQ(BT)(E¯), to characterize the photon radiation quality in view of measurements of distributions of the absorbed dose to water, Dw, around BT sources. MATERIALS AND METHODS While the external photon beam radiotherapy (EBRT) radiation quality index Q(EBRT)(E¯)=TPR10(20)(E¯) is not applicable to BT, the authors have applied a novel energy dependent parameter, called brachytherapy photon radiation quality index, defined as Q(BT)(E¯)=Dprim(r=2cm,θ0=90°)/Dprim(r0=1cm,θ0=90°), utilizing precise primary absorbed dose data, Dprim, from source reference databases, without additional MC-calculations. RESULTS AND DISCUSSION For BT photon sources used clinically, Q(BT)(E¯) enables to determine the effective mean linear attenuation coefficient μ¯(E) and thus the effective energy of the primary photons Eprim(eff)(r0,θ0) at the TG-43 reference position Pref(r0=1cm,θ0=90°), being close to the mean total photon energy E¯tot(r0,θ0). If one has calibrated detectors, published E¯tot(r) and the BT radiation quality correction factor [Formula: see text] for different BT radiation qualities Q and Q0, the detector's response can be determined and Dw(r,θ) measured in the vicinity of BT photon sources. CONCLUSIONS This novel brachytherapy photon radiation quality indexQ(BT) characterizes sufficiently accurate and precise the primary photon's penetration probability and scattering potential.
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Affiliation(s)
- Ulrich Quast
- Ex-University Hospital, Radiation Oncology Dept., Clinical Radiation Physics, D 45127 Essen, Germany.
| | - Theodor W Kaulich
- University-Hospital, Dept. of Radiation Oncology, Medical Physics, D 72076 Tübingen, Germany
| | | | - Sa Carlsson Tedgren
- Radiation Physics, IMH, Linköping University, SE 58185 Linköping, Sweden; Radiotherapy Physics and Engineering, Dept. of Medical Physics, Karolinska University Hospital, Stockholm, Sweden
| | - Shirin A Enger
- Medical Physics Unit, Dept. of Oncology, McGill University, CA H3AO64, Montréal, Québec, Canada
| | - David C Medich
- Dept. of Physics, Worcester Polytechnic Institute, Worcester, MA 01609, USA
| | - Firas Mourtada
- Radiation Oncology Dept., Helen F. Graham Cancer Center & Research Institute, Newark, DE 19713, USA
| | - Jose Perez-Calatayud
- Radiotherapy Dept., University Hospital La Fe, 46026 Valencia, Spain and Clinica Benidorm, Alicante, Spain
| | - Mark J Rivard
- Dept. of Radiation Oncology, Tufts University School of Medicine, Boston, MA 02111, USA
| | - G Abu Zakaria
- Gummersbach Hospital, University of Cologne, Med. Rad. Physics, D 51643 Gummersbach, Germany; Dept. of Medical Physics and Biomedical Engineering, Gono University, Dhaka 1344, Bangladesh
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Chicas-Sett R, Perez-Calatayud J, Bautista-Ballesteros J, Celada F, Roldán S, Torregrosa A, Betancourt J, Farga-Albiol D, Carmona V, Tormo A. An Evaluation of the Robustness of the Organ-at-Risk Recommendations Made by GEC/ESTRO According to Inter- and Intra- Observer Variability: A Single Center Experience. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Granero D, Candela-Juan C, Vijande J, Ballester F, Perez-Calatayud J, Jacob D, Mourtada F. Dosimetric Deviation of Leipzig and Valencia Skin Applicators When Used without Cap. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Vijande J, Ballester F, Candela-Juan C, Niatsetski Y, van der Laarse R, Graneero D, Perez-Calatayud J. New HDR Valencia Applicator for Treating Skin Lesions Larger Than 3 cm Size with Either a Co-60 or Ir-192 Source. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Rodriguez S, Otal A, Richart J, Perez-Calatayud J, Cañon R, Santos M. Interstitial Brachytherapy in Locally Advanced Cervical Cancer: From MUPIT to Full Compatible MRI Mixed Intracavitary/Interstitial Template. 10 Years of Experience. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rodriguez S, Otal A, Richart J, Perez-Calatayud J, Santos M. Pre-Plan Technique Feasibility in Multi-Interstitial Gynecological Brachytherapy. Brachytherapy 2016. [DOI: 10.1016/j.brachy.2016.04.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Granero D, Candela-Juan C, Vijande J, Ballester F, Perez-Calatayud J, Jacob D, Mourtada F. Technical Note: Dosimetry of Leipzig and Valencia applicators without the plastic cap. Med Phys 2016; 43:2087. [DOI: 10.1118/1.4944784] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Chicas-Sett R, Bautista-Ballesteros J, Celada-Alvarez F, Roldán S, Torregrosa A, Betancourt J, Burgos J, Farga D, Perez M, Carmona V, Tormo A, Benlloch J, Perez-Calatayud J. EP-2008: Robustness of the OARs recommendations made by GEC-ESTRO according to inter-observer variability. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33259-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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