AAPM recommendations on medical physics practices for ocular plaque brachytherapy: Report of task group 221.

The American Association of Physicists in Medicine (AAPM) formed Task Group 221 (TG-221) to discuss a generalized commissioning process, quality management considerations, and clinical physics practice standards for ocular plaque brachytherapy. The purpose of this report is also, in part, to aid the clinician to implement recommendations of the AAPM TG-129 report, which placed emphasis on dosimetric considerations for ocular brachytherapy applicators used in the Collaborative Ocular Melanoma Study (COMS). This report is intended to assist medical physicists in establishing a new ocular brachytherapy program and, for existing programs, in reviewing and updating clinical practices.

A brachytherapy photon radiation quality index Q(BT) for probe-type dosimetry.

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.

Comparison of different adjuvant radiotherapy approaches in childhood bladder/prostate rhabdomyosarcoma treated with conservative surgery.

Background And Purpose: Multimodality treatment approaches provide high local control and satisfying overall survival (OS) for children with localized bladder and/or prostate rhabdomyosarcoma (BP-RMS). However, current strategies including surgery and conventional radiotherapy are compromised by high rates of long-term genitourinary adverse effects. Therefore, a planning study combining organ preserving surgery with three different innovative adjuvant radiotherapy approaches was performed.

Radiation protection of persons living close to patients with radioactive implants.

Background: Permanent interstitial brachytherapy is--in certain cases--a very successful therapeutic option, but application of radioactive implants always results in only gradually diminishing radiation exposure of persons in the patient's immediate surroundings.

Material And Methods: Using patients with clinically localized prostate cancer treated with iodine-125 ((125)I) or palladium-103 ((103)Pd) as an example, it is shown how a patient, if necessary or wished by him, can, by wearing commercially available X-ray protection shorts, reduce radiation exposure of family members in such a way that at a distance r from the patient a given dose per year is not exceeded.

Results: The computational procedures necessary for the determination of the individual periods of wearing X-ray protection clothing are provided in the form of formulae and graphics.

Clinical quality assurance for 106Ru ophthalmic applicators.

Background And Purpose: Episcleral brachytherapy using 106Ru/106Rh ophthalmic applicators is a proven method of therapy of uveal melanomas sparing the globe and in many cases sparing the vision. In the year 2001, an internal clinical quality assurance procedure revealed that part of the ophthalmic applicators leaked and that the calibration was erroneous. Consequently, the producer modernized its production procedures and, in May 2002, introduced a dose rate calibration that is traceable to the NIST standard.

On the actual state of industrial quality assurance procedures with regard to (106)Ru ophthalmic plaques.

Background: In radiotherapy of intraocular tumors, e. g., in the case of malign choroid melanomas, episcleral brachytherapy with (106)Ru ophthalmic plaques has proven to be successful.

Clinical beta radiation dosimetry for brachytherapy in terms of absorbed dose to water: ISO new work item proposal for international standardization.

Purpose: Beta radiation has found increasing interest in intravascular brachytherapy for successfully overcoming the severe problem of restenosis after interventional treatment of arterial stenosis. Prior to initiating procedures applying beta radiation there is a common need to specify methods for the determination and specification of the absorbed dose to water or tissue and their spatial distributions. The DIN-NAR standardization in radiology task group Dosimetry has initiated an international ad hoc working group for an ISO new work item proposal on the standardization of procedures in clinical beta radiation dosimetry.

[Physical and technical quality assurance and radiation protection in transperineal interstitial permanent prostate brachytherapy with 125-iodine seeds].

Background: Early stage prostate cancer can be treated successfully by interstitial brachytherapy with 125-iodine seeds. A quality-assurance programme is presented that was designed for this purpose for internal clinical use. Furthermore the requirements of the new German Ordinance Governing Radiation Protection (StrlSchV) that came into force on August 1, 2001, are taken into account.

[Physical basics and clinical realization of interstitial brachytherapy of the prostate with iodine 125].

Background: Interstitial brachytherapy with I-125 seeds can be used for successful treatment of early stage prostate cancer. There is presented the technique of permanent transperineal implantation of I-125 seeds with intraoperative treatment planning which is suited for the treatment of prostate cancer up to the clinical stage of T2a.

Material And Methods: Some weeks before the implantation of the seeds the prostate volume is determined using transrectal ultrasound (TRUS) so as to estimate the required number of I-125 seeds.

[Optimal intravascular brachytherapy: safety and radiation protection, reliability and precision guaranteed by guidelines, recommendations and regulatory requirements].

Background: The success of intravascular brachytherapy relies entirely on the interdisciplinary approach. Interventional cardiologists, radiation oncologists and medical physicists must form a team from day 1. All members of the team need special knowledge and regular training in the field of vascular radiation therapy.