Safety and Efficacy of Brachytherapy in Inoperable Endometrial Cancer.

: Radiotherapy represents the only treatment option for patients with inoperable endometrial cancer (EC). The aim of our study was to evaluate the efficacy and safety of brachytherapy (BT) in this selected patient population. : Between 1990 and 2019, 18 patients with inoperable EC in stage FIGO I-IV were treated with intracavitary brachytherapy using the "Heyman Packing technique".

Outcomes of I-125 Low-Dose-Rate Brachytherapy in Patients with Localized Prostate Cancer: A Comprehensive Analysis from a Specialized Tertiary Referral Center.

Low-dose-rate (LDR) brachytherapy with I-125 seeds is one of the most common primary tumor treatments for low-risk and low-intermediate-risk prostate cancer. This report aimed to present an analysis of single-institution long-term results. We analyzed the treatment outcomes of 119 patients with low- and intermediate-risk prostate cancer treated with LDR brachytherapy at our institution between 2014 and 2020.

Brachytherapy in vaginal cancer for organ preservation: Clinical outcome and safety from a single center experience.

Background: Interstitial and/or intracavitary brachytherapy is an integral part of the treatment of vaginal cancer Brachytherapy (BT) has shown to improve local control, overall survival (OS) and disease-free survival (DFS). The aim of our study was to analyze the efficacy and safety of brachytherapy in patients with vaginal cancer.

Materials And Methods: Between 2000 and 2023, 27 patients with vaginal cancer in stage FIGO I-III were treated with brachytherapy with or without external beam radiotherapy (EBRT) and simultaneous chemotherapy.

Protocol-based CT-guided brachytherapy for patients with prostate cancer and previous rectal extirpation-a curative approach.

Objective: There are numerous curative treatment possibilities for prostate cancer. In patients who have undergone rectal extirpation for rectal cancer treatment, curative options are limited due to anatomic changes and previous irradiation of the pelvis. In this analysis, we validate the feasibility of CT-guided transperineal interstitial brachytherapy for this specific scenario.

Inter-observer effects in needle reconstruction for temporary prostate brachytherapy: Dosimetric implications and adaptive CBCT-TRUS registration solutions.

Purpose: To investigate geometric and dosimetric inter-observer variability in needle reconstruction for temporary prostate brachytherapy. To assess the potential of registrations between transrectal ultrasound (TRUS) and cone-beam computed tomography (CBCT) to support implant reconstructions.

Methods And Materials: The needles implanted in 28 patients were reconstructed on TRUS by three physicists.

Investigating the impact of breast positioning control on physical treatment parameters in multi-catheter breast brachytherapy.

Purpose: To assess the effects of a workflow for reproducible patient and breast positioning on implant stability during high-dose-rate multi-catheter breast brachytherapy.

Methods: Thirty patients were treated with our new positioning control workflow. Implant stability was evaluated based on a comparison of planning-CTs to control-CTs acquired halfway through the treatment.

On the implant stability in adaptive multi-catheter breast brachytherapy: Establishment of a decision-tree for treatment re-planning.

Background And Purpose: To assess implant stability and identify causes of implant variations during high-dose-rate multi-catheter breast brachytherapy.

Materials And Methods: Planning-CTs were compared to control-CTs acquired halfway through the treatment for 100 patients. For assessing geometric stability, Fréchet-distance and button-to-button distance changes of all catheters as well as variations of Euclidean distances and convex hulls of all dwell positions were determined.

Seed-displacements in the immediate post-implant phase in permanent prostate brachytherapy.

Purpose: To investigate differences in seed-displacements between the immediate post-implant phase (day 0-1) and the time to post-plan computed tomography (CT) (day 1-30) in seed prostate brachytherapy.

Materials And Methods: Seed positions were identified on the intra-operatively created ultrasound-based treatment plan (day 0) and CT scans of day 1 and 30 for 33 patients. The day 1 (30) seed arrangement was registered onto the day 0 (1) arrangement using a seed-only approach.

Automating implant reconstruction in interstitial brachytherapy of the breast: A hybrid approach combining electromagnetic tracking and image segmentation.

Background And Purpose: To develop a method for automatic reconstruction of catheter implants in interstitial brachytherapy (iBT) of the breast by means of electromagnetic tracking (EMT) with the goal of making treatment planning as time-effective and accurate as possible.

Materials And Methods: The implant geometry of 64 patients was recorded using an afterloader prototype with EMT functionality immediately after the planning CT. EMT data were transferred to the CT image space by rigidly registering the catheter fixation buttons as landmarks.

Permanent LDR prostate brachytherapy: Comprehensive characterization of seed-dynamics within the prostate on a seed-only level.

Purpose: Seed brachytherapy is a well-established treatment modality for prostate cancer. However, there is still a lack of profound characterizations of seed motions within the prostate. We assessed these dynamics between day 0 and day 30 of brachytherapy.

Brachytherapy focal dose escalation using ultrasound based tissue characterization by patients with non-metastatic prostate cancer: Five-year results from single-center phase 2 trial.

Purpose: This prospective trial investigates side effects and efficacy of focal dose escalation with brachytherapy for patients with prostate cancer.

Methods And Materials: In the Phase II, monocentric prospective trial 101 patients with low-/intermediate- and high-risk prostate cancer were enrolled between 2011 and 2013. Patients received either PDR-/HDR-brachytherapy alone with 86-90 Gy (EQD2, α/β = 3 Gy) or PDR-/HDR-brachytherapy as boost after external beam radiation therapy up to a total dose of 91-96 Gy (EQD2, α/β = 3 Gy).

First clinical experience with a novel, mobile cone-beam CT system for treatment quality assurance in brachytherapy.

Background And Purpose: On-site cone-beam computed tomography (CBCT) has gained in importance in adaptive brachytherapy during recent years. Besides treatment planning, there is increased need particularly for image-guidance during interventional procedures and for image-guided treatment quality assurance (QA). For this purpose, an innovative CBCT device was rolled out at our hospital as the first site worldwide.

Long-term results of a protocol-based ultrasound-guided salvage brachytherapy as re-irradiation for local recurrent prostate cancer.

Background And Purpose: To assess the long-term results of protocol-based ultrasound-guided salvage pulsed-dose rate brachytherapy in locally recurrent prostate cancer following previous radiation therapy.

Materials And Methods: A total of 82 patients (median age 69 years) with locally recurrent prostate cancer after previous external beam radiation therapy (43/82, 52.4%), prostatectomy and adjuvant radiation therapy (24/82, 29.

Is adaptive treatment planning in multi-catheter interstitial breast brachytherapy necessary?

Purpose: For 55 patients treated with interstitial multi-catheter breast brachytherapy the need for adaptive treatment planning was assessed.

Methods And Materials: For all patients a treatment planning computed tomography (CT) and a follow-up CT were acquired and used for the retrospective evaluation. Keeping dwell time and dwell positions constant, the treatment plan assessed directly after catheter implantation was compared to the situation 48 h after implantation.

Estimation of inter-fractional variations in interstitial multi-catheter breast brachytherapy using a hybrid treatment delivery system.

Purpose: Irradiation of the tumor bed using interstitial multi-catheter brachytherapy is one of the treatment options for breast cancer patients. In order to ensure the planned dose delivery an advanced quality intervention method using an electromagnetic tracking (EMT) system is presented. The system is used to assess inter-fractional variations within the framework of a patient study.

Impact of inter- and intra-observer variabilities of catheter reconstruction on multi-catheter interstitial brachytherapy of breast cancer patients.

Purpose: The aim of this study was to evaluate inter- and intra-observer variabilities of catheter reconstruction and its dosimetric impact for multi-catheter interstitial breast cancer patients.

Methods And Materials: In order to evaluate inter-observer variabilities (IOV) three medical physicists reconstructed the catheter traces of 13 patients. These manual reconstructions were further compared to the automatic reconstruction algorithm integrated into the planning system and one on purpose imprecise manual reconstruction.

Introduction of a hybrid treatment delivery system used for quality assurance in multi-catheter interstitial brachytherapy.

Multi-catheter interstitial brachytherapy (iBT) is a treatment option for breast cancer patients after breast conserving surgery. Typically, only a few additional quality interventions after the first irradiation have been introduced to ensure the planned treatment delivery. Therefore, the purpose of this study is to show the possibilities of an electromagnetic tracking (EMT) system integrated into the afterloader for quality assurance (QA) in high-dose rate (HDR) iBT of patients with breast cancer.

Electromagnetic tracking (EMT) technology for improved treatment quality assurance in interstitial brachytherapy.

Electromagnetic Tracking (EMT) is a novel technique for error detection and quality assurance (QA) in interstitial high dose rate brachytherapy (HDR-iBT). The purpose of this study is to provide a concept for data acquisition developed as part of a clinical evaluation study on the use of EMT during interstitial treatment of breast cancer patients. The stability, accuracy, and precision of EMT-determined dwell positions were quantified.

Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy: Long-term results.

Purpose: To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy as reirradiation combined with simultaneous chemotherapy and interstitial hyperthermia in selected patients with recurrent head and neck tumors.

Materials And Methods: A total of 104 patients with biopsy-proven recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Salvage surgery had also been undergone by 53/104 (51%) patients (R1 or R2 resection in > 80% of patients).

Re-irradiation with interstitial pulsed-dose-rate brachytherapy for unresectable recurrent head and neck carcinoma.

Purpose: To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy combined with simultaneous chemotherapy in selected patients with recurrent head and neck tumors not amenable to salvage surgery.

Methods And Materials: A total of 51 patients with recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Forty patients (78%) had salvage brachytherapy alone using a median total dose of 60 Gy.

Interstitial pulsed-dose-rate brachytherapy for head and neck cancer--Single-institution long-term results of 385 patients.

Purpose: To assess the long-term results of protocol-based pulsed-dose-rate (PDR) interstitial brachytherapy (iBT) in 385 patients with head and neck cancer who underwent PDR-iBT preferably after minimal, nonmutilating surgery.

Methods And Materials: From 1997 to 2009, a total of 385 patients received protocol-based PDR-iBT for head and neck cancer. Brachytherapy was preceded by surgery in most of our patients (326/385, 84.

Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy.

Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects.

Patients And Methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.

Long term results of a prospective dose escalation phase-II trial: interstitial pulsed-dose-rate brachytherapy as boost for intermediate- and high-risk prostate cancer.

Purpose: We reviewed our seven year single institution experience with pulsed dose rate brachytherapy dose escalation study in patients with intermediate and high risk prostate cancer.

Materials And Methods: We treated a total of 130 patients for intermediate and high risk prostate cancer at our institution between 2000 and 2007 using PDR-brachytherapy as a boost after conformal external beam radiation therapy to 50.4 Gy.

Radiation exposure of the heart, lung and skin by radiation therapy for breast cancer: a dosimetric comparison between partial breast irradiation using multicatheter brachytherapy and whole breast teletherapy.

Background And Purpose: Accelerated partial breast irradiation by means of multicatheter brachytherapy shows great promise in the modern treatment of early breast cancer combining high efficacy in preventing tumour recurrence with low levels of toxicity. The present work attempts a dosimetric comparison between this treatment modality and conventional whole breast external beam radiotherapy by looking at differences in risk organ exposure to radiation.

Patients And Methods: The planning CT data sets of 16 consecutive patients with left-sided breast cancer who received external beam radiotherapy to the whole breast followed by a boost to the tumour bed using multicatheter interstitial brachytherapy after breast conserving surgery were used to create two independent physical treatment plans - one for an external radiotherapy, one for sole partial breast brachytherapy in each case assuming a total reference dose of 50Gy for each patient.