Experiences With HDR-brachytherapy in Norway
Condition: Prostate Cancer Intervention: Radiation: High-Dose Rate Brachytherapy Sponsors: Oslo University Hospital; University of Oslo Completed - verified May 2017
This has reference to the research article “Total reference air kerma can accurately predict isodose surface volumes in cervix cancer brachytherapy. A multicenter study.” published in your esteemed journal. The publication is good and informative; we wish to clarify following statements.
We report feasibility and early outcomes with the use of these hybrid applicators at our institution.
India has a longstanding tradition in the practice of brachytherapy and has actively contributed to the scientific literature by conducting prospective studies, clinical audits, developing innovative techniques, and performing randomized studies. Indian investigators have also contributed to international collaborative research, education, training programs along with guideline development for brachytherapy in cervix and head and neck cancers. The present article summarizes the key contributions to scientific literature, current infrastructure, skill set for brachytherapy, existing challenges, and strategy to further stren...
The recent update of the web-based GEC-ESTRO handbook of brachytherapy  has brought into attention the lack of standardized constraints based on dose volume histogram (DVH) data in head and neck brachytherapy. This is specially noteworthy in an anatomical area where treatment complications may be severe in a substantial number of cases.
Brachytherapy (BT) is an essential component of definitive therapy for locally advanced cervical cancer. Despite the advantages of the dose distribution with BT in cervical cancer, there is paucity of specific skills required for good-quality BT applications. Furthermore, replacing BT with other modern external beam techniques as a boost can lead to suboptimal results in cervix cancer.
In this study, we investigate the role of diffusion-weighted imaging –derived apparent diffusion coefficient (ADC) maps to aid in IGABT.
The natural history of radiorecurrent of high-risk prostate cancer (HRPCa) is poorly understood, despite the proportionally higher rates of BCR in this risk group. Treatment HRPCa with external beam radiotherapy (EBRT) plus brachytherapy (BT) boost (EBRT+BT) has been associated with lower rates of BCR, distant metastasis (DM), and PCa-specific mortality (PCSM) compared to EBRT alone. However, it is unclear whether patients who develop BCR following either approach have similar downstream oncologic outcomes.
Cervical brachytherapy (BT) is a critical component in the definitive treatment for patients with cervical cancer. Current American Brachytherapy Society and GEC-ESTRO Working group guidelines recommend a 3D treatment planning approach for cervical brachytherapy1-3. Tumor delineation using magnetic resonance imaging (MRI) is superior to CT-guided contouring, resulting in improved local control, cancer specific survival, and overall survival4. Unfortunately, the logistics and cost of obtaining post implantation MRI is impractical for most Radiation Oncology Departments.
The standard of care for patients with endometrial cancer typically involves upfront surgery. External beam radiotherapy, brachytherapy, and/or chemotherapy are implemented in the adjuvant setting based on individual risk factors. In the subset of women who are unable to receive surgery due to medical comorbidities or tumor-related factors, external beam radiation and/or uterine brachytherapy can be employed in the definitive setting.
Vaginal stenosis (VS) is a known complication of pelvic radiotherapy resulting from high radiation doses delivered to significant portions of the vaginal canal. VS not only decreases patient quality of life as it can interfere with sexual function, but, importantly, it also precludes the ability to perform an adequate speculum exam to assess for tumor recurrence in the follow up period. The incidence of VS varies in the published literature and depends on patient and treatment-related factors, including cancer type, cancer stage, radiation type and total dose, and adherence to vaginal dilator use.