EQD2 and Overall Treatment Time in the High Dose Rate Brachytherapy of the Advanced Nasopharyngeal Carcinoma

2016 ◽  
Vol 0 (5) ◽  
Author(s):  
Arunkumar Sharma
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Dose Rate ◽  
Treatment Time ◽  
High Dose Rate ◽  
High Dose ◽  
Overall Treatment Time ◽  
High Dose Rate Brachytherapy

Adjuvant High-Dose Rate Brachytherapy After Chemoradiation for Treatment of Early T-Stage Nasopharyngeal Carcinoma

2004 ◽  
Vol 27 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Jiade J. Lu ◽  
Thomas Shakespeare ◽  
Boon Cher Goh ◽  
Chua Eu Tiong ◽  
Michael Back ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Dose Rate ◽  
High Dose Rate ◽  
High Dose ◽  
High Dose Rate Brachytherapy ◽  
T Stage

Fractionated high-dose-rate brachytherapy in primary carcinoma of the nasopharynx.

1998 ◽  
Vol 16 (6) ◽  
pp. 2213-2220 ◽  
Author(s):  
P C Levendag ◽  
P I Schmitz ◽  
P P Jansen ◽  
W M Eijkenboom ◽  
A G Visser ◽  
...  
Keyword(s):  
Dose Rate ◽  
Treatment Time ◽  
Univariate Analysis ◽  
High Dose Rate ◽  
Local Failure ◽  
Dose Effect ◽  
High Dose ◽  
Outpatient Basis ◽  
Overall Treatment Time ◽  
Prognostic Group

PURPOSE A growing body of data suggests that local control in nasopharyngeal cancer (NPC) is related to the radiation dose administered. We conducted a single-institution study of high-dose radiotherapy (RT), which incorporated high-dose-rate (HDR) brachytherapy (BT). These results were analyzed together with data obtained from controls who did not receive BT. PATIENTS AND METHODS The BT group comprised 42 consecutive patients of whom 29 patients were staged according to the tumor, node, metastasis system as T1 through 3, 13 patients were T4, and 34 patients were N+ disease. BT was administered on an outpatient basis by means of a specially designed flexible nasopharyngeal applicator, and the dose distributions were optimized. Treatment for T1 through 3 tumors comprised 60 Gy of external-beam radiotherapy (ERT) followed by six fractions of 3 Gy BT (two fractions per day). Patients with parapharyngeal tumor extension and/or T4 tumors received 70 Gy ERT and four fractions of 3 Gy BT. The no-BT group consisted of all patients treated from 1965 to 1991 (n = 109), of whom 82 patients had stages T1 through 3, 27 patients had T4, and 80 patients had N+ disease. Multivariate Cox proportional hazards analyses were performed by using the end points time to local failure (TTLF), time to distant failure (TTDF), disease-free survival (DFS), cause-specific survival (CSS), and the prognostic factors age, tumor stage, node stage, and grade. Because the overall treatment time varied substantially in the no-BT group, the dependence of local failure (LF) on the physical dose as well as the biologic effective dose (BED) corrected for the overall treatment time (OTT) (BEDcor10) was studied. RESULTS The BT group had a superior 3-year local relapse-free rate (86% v 60%; univariate analysis, P = .004). Multivariate analysis showed hazards ratios for BT versus no-BT of 0.24 for TTLF (P = .003), 0.35 for TTDF (P = .038), 0.31 for DFS (P < .001), and 0.44 for CSS (P = .01). The best prognostic group consisted of patients with T1 through 3, N0 through 2b tumors treated with BT who attained a 5-year TTLF of 94% and CSS of 91%. In contrast, the worst prognostic group, i.e., 5-year TTLF of 47% and CSS of 24%, was composed of patients with T4 and/or N2c through 3 tumors who did not receive BT. CONCLUSION High doses of radiation (73 to 95 Gy) can be administered to patients with NPC with minimal morbidity by means of optimized HDR-BT. The use of a BT boost proved to be of significant benefit, particularly in patients with T1 through 3, N0 through 2b disease. The steep dose-effect relationship seen for the physical dose and the BEDcor10 indicates that the results are dose related. The analysis has identified a poor prognostic group in whom treatment intensification with chemotherapy (CHT) is indicated.

High dose rate brachytherapy with surface applicators: Treatment for nonmelanomatous skin cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15543-15543 ◽  
Author(s):  
J. Musmacher ◽  
M. Ghaly ◽  
K. Satchwill
Keyword(s):  
Dose Rate ◽  
Dose Distribution ◽  
Treatment Time ◽  
High Dose Rate ◽  
High Dose ◽  
Outpatient Basis ◽  
Hdr Brachytherapy ◽  
X Rays ◽  
High Dose Rate Brachytherapy ◽  
Lateral Canthus

15543 Background: To assess the use of HDR surface applicators as an alternative radiotherapy modality to external radiation (electrons or low-energy x-rays) for the treatment of skin lesions of the head and neck. Skin carcinomas require efficient and accurate delivery of HDR Brachytherapy, which can be precisely reproduced on an outpatient basis. Methods: Patients were treated to various sites, which included lesions of the face and scalp. Thermoplastic casts were fitted with Leipzig Surface Applicators and custom molded to the patient to treat squamous or basal cell carcinomas ≤ 2 cm in diameter. A custom surface mold applicator (Freiburg Flap) was used for lesions up to 4 cm. Planning target volume included the tumor plus a 5 mm margin. Biweekly photographs of the treatment volume were taken for documentation and monitoring of radiation reactions. Treatment was delivered by HDR Brachytherapy (Ir-192), 5 Gy per fraction, twice per week for four weeks to a 5 mm depth. TLD’s were placed at the center of the treated volume under the applicator and at critical structures (i.e. lateral canthus of the ipsilateral eye, auditory canal or gingivolabial sulcus) twice during the course of treatment. Results: Patients’ setup and reproducibility were accurate and treatment time was short which added great convenience for the patients. With the HDR surface applicators, dose distribution was uniform in the surface of the skin and at 5 mm depth in the whole area of the applicator. Differences between the areas of maximum and minimum dose at this depth did not reach values higher than 5% of the prescribed dose. At the edges of the applicators, the dose gradient was sharp, with the detected dose at 5 mm from the applicator being negligible. An exudative radiation reaction was noted in some patients, which reversed with appropriate therapy. Conclusion: High Dose Rate Brachytherapy offers a highly effective treatment of skin carcinomas. Surface applicators, used in conjunction with HDR brachytherapy equipment, make a uniform dose distribution and sharp dose gradient at the edge of the treatment field. Surface applicators are easy and safe to use, and they fit very accurately for each fraction. These applicators have the ability to become the standard treatment for skin carcinomas in the near future. No significant financial relationships to disclose.

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