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Advances in Brachytherapy in the Treatment of Tumors
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Advances in Brachytherapy in the Treatment of Tumors

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2024 | Viewed by 11355

Special Issue Editor

Dr. Hideya Yamazaki

E-Mail Website
Guest Editor
Department of Radiology, Kyoto Prefectural University Graduate School of Medical Science, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Interests: radiation oncology

Special Issue Information

Dear Colleagues,

Brachytherapy is the oldest and first successful radiotherapeutic procedure which continues to have the best dose distribution among all radiotherapy techniques even today if adequately used. Brachytherapy enables us to deliver a higher dose of radiation to a tumor than might be possible with conventional external radiation therapy while minimizing damage to the surrounding normal tissue. Therefore, brachytherapy is a fascinating procedure to destroy cancer cells in a broad type of cancers—prostate cancer, breast cancer, head and neck cancer, brain tumor, liver cancer, gynecological tumors such as cervical cancer, etc. With the advent of advanced imaging modality, brachytherapy has attracted increased attention in the 21st century. For instance, the EMBRACE project improved outcomes of cervical cancer using MRI images with the MRI-enabled applicator and interstitial implantation technique. In prostate cancer treatment, in addition to the LDR technique using ultrasound and CT images, the HDR technique widened its applicability using MRI imaging. Recent exploration of dominant intraprostatic lesion (DIL) boost has the potential to improve outcomes without elevating toxicity. Here, we welcome papers enhancing the role of brachytherapy in medicine.  

Dr. Hideya Yamazaki
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • brachytherapy
  • LDR
  • HDR
  • PDR
  • cervical cancer
  • prostate cancer
  • breast cancer

Published Papers (5 papers)

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Research

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13 pages, 2505 KiB  
Article
Prognostic Factors Analysis of Metastatic Recurrence in Cervical Carcinoma Patients Treated with Definitive Radiotherapy: A Retrospective Study Using Mixture Cure Model
by Xiaxian Ou, Jing You, Baosheng Liang, Xiaofan Li, Jiangjie Zhou, Fengyu Wen, Jingyuan Wang, Zhengkun Dong and Yibao Zhang
Cancers 2023, 15(11), 2913; https://doi.org/10.3390/cancers15112913 - 25 May 2023
Viewed by 1230
Abstract
Objectives: This study aims to identify prognostic factors associated with metastatic recurrence-free survival of cervical carcinoma (CC) patients treated with radical radiotherapy and assess the cure probability of radical radiotherapy from metastatic recurrence. Methods: Data were from 446 cervical carcinoma patients with radical [...] Read more.
Objectives: This study aims to identify prognostic factors associated with metastatic recurrence-free survival of cervical carcinoma (CC) patients treated with radical radiotherapy and assess the cure probability of radical radiotherapy from metastatic recurrence. Methods: Data were from 446 cervical carcinoma patients with radical radiotherapy for an average follow up of 3.96 years. We applied a mixture cure model to investigate the association between metastatic recurrence and prognostic factors and the association between noncure probability and factors, respectively. A nonparametric test of cure probability under the framework of a mixture cure model was used to examine the significance of cure probability of the definitive radiotherapy treatment. Propensity-score-matched (PSM) pairs were generated to reduce bias in subgroup analysis. Results: Patients in advanced stages (p = 0.005) and those with worse treatment responses in the 3rd month (p = 0.004) had higher metastatic recurrence rates. Nonparametric tests of the cure probability showed that 3-year cure probability from metastatic recurrence was significantly larger than 0, and 5-year cure probability was significantly larger than 0.7 but no larger than 0.8. The empirical cure probability by mixture cure model was 79.2% (95% CI: 78.6–79.9%) for the entire study population, and the overall median metastatic recurrence time for uncured patients (patients susceptible to metastatic recurrence) was 1.60 (95% CI: 1.51–1.69) years. Locally advanced/advanced stage was a risk factor but non-significant against the cure probability (OR = 1.078, p = 0.088). The interaction of age and activity of radioactive source were statistically significant in the incidence model (OR = 0.839, p = 0.025). In subgroup analysis, compared with high activity of radioactive source (HARS), low activity of radioactive source (LARS) significantly contributed to a 16.1% higher cure probability for patients greater than 53 years old, while cure probability was 12.2% lower for the younger patients. Conclusions: There was statistically significant evidence in the data showing the existence of a large amount of patients cured by the definitive radiotherapy treatment. HARS is a protective factor against metastatic recurrence for uncured patients, and young patients tend to benefit more than the elderly from the HARS treatment. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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14 pages, 2772 KiB  
Article
A User-Friendly System for Mailed Dosimetric Audits of 192Ir or 60Co HDR Brachytherapy Sources
by Laura Oliver-Cañamás, Javier Vijande, Cristian Candela-Juan, Jose Gimeno-Olmos, Mª Carmen Pujades-Claumarchirant, Juan J. Rovira-Escutia, Facundo Ballester and Jose Perez-Calatayud
Cancers 2023, 15(9), 2484; https://doi.org/10.3390/cancers15092484 - 26 Apr 2023
Cited by 1 | Viewed by 1111
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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9 pages, 680 KiB  
Article
Dose Distribution of High Dose-Rate and Low Dose-Rate Prostate Brachytherapy at Different Intervals—Impact of a Hydrogel Spacer and Prostate Volume
by Hathal Haddad, Horst Hermani, Herbert Hanitzsch, Albert Heidrich and Michael Pinkawa
Cancers 2023, 15(5), 1396; https://doi.org/10.3390/cancers15051396 - 22 Feb 2023
Cited by 1 | Viewed by 1651
Abstract
The study aimed to compare the dose distribution in permanent low-dose-rate brachytherapy (LDR-BT) and high-dose-rate brachytherapy (HDR-BT), specifically focusing on the impact of a spacer and prostate volume. The relative dose distribution of 102 LDR-BT patients (prescription dose 145 Gy) at different intervals [...] Read more.
The study aimed to compare the dose distribution in permanent low-dose-rate brachytherapy (LDR-BT) and high-dose-rate brachytherapy (HDR-BT), specifically focusing on the impact of a spacer and prostate volume. The relative dose distribution of 102 LDR-BT patients (prescription dose 145 Gy) at different intervals was compared with the dose distribution of 105 HDR-BT patients (232 HDR-BT fractions with prescription doses of 9 Gy, n = 151, or 11.5 Gy, n = 81). A hydrogel spacer (10 mL) was only injected before HDR-BT. For the analysis of dose coverage outside the prostate, a 5 mm margin was added to the prostate volume (PV+). Prostate V100 and D90 of HDR-BT and LDR-BT at different intervals were comparable. HDR-BT was characterized by a considerably more homogenous dose distribution and lower doses to the urethra. The minimum dose in 90% of PV+ was higher for larger prostates. As a consequence of the hydrogel spacer in HDR-BT patients, the intraoperative dose at the rectum was considerably lower, especially in smaller prostates. However, prostate volume dose coverage was not improved. The dosimetric results well explain clinical differences between these techniques reported in the literature review, specifically comparable tumor control, higher acute urinary toxicity rates in LDR-BT in comparison to HDR-BT, decreased rectal toxicity after spacer placement, and improved tumor control after HDR-BT in larger prostate volumes. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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14 pages, 3123 KiB  
Article
High-Dose-Rate Brachytherapy as an Organ-Sparing Treatment for Early Penile Cancer
by Denisa Pohanková, Igor Sirák, Milan Vošmik, Linda Kašaová, Jakub Grepl, Petr Paluska, Lukáš Holub, Jiří Špaček, Miroslav Hodek, Martin Kopeček and Jiří Petera
Cancers 2022, 14(24), 6248; https://doi.org/10.3390/cancers14246248 - 19 Dec 2022
Cited by 2 | Viewed by 3805
Abstract
Background: Low-dose-rate brachytherapy is an effective organ-sparing treatment for patients with early-stage penile cancer. However, only limited data are available on the role of high-dose-rate brachytherapy (HDR-BT) in this clinical setting. Methods: Between 2002 and 2020, 31 patients with early penile cancer were [...] Read more.
Background: Low-dose-rate brachytherapy is an effective organ-sparing treatment for patients with early-stage penile cancer. However, only limited data are available on the role of high-dose-rate brachytherapy (HDR-BT) in this clinical setting. Methods: Between 2002 and 2020, 31 patients with early penile cancer were treated at our center with interstitial HDR BT at a dose of 18 × 3 Gy twice daily. A breast brachytherapy template was used for the fixation of stainless hollow needles. Results: The median follow-up was 117.5 months (range, 5–210). Eight patients (25.8%) developed a recurrence; of these, seven were salvaged by partial amputation. Six patients died of internal comorbidities or a second cancer. The probability of local control at 5 and 10 years was 80.7% (95% CI: 63.7–97.7%) and 68.3% (95% CI: 44.0–92.6%), respectively. Cause-specific survival was 100%. Only one case of radiation-induced necrosis was observed. The probability of penile sparing at 5 and 10 years was 80.6% (95% CI: 63.45–97.7%) and 62.1% (95% CI: 34.8–89.4%), respectively. Conclusions: These results show that HDR-BT for penile cancer can achieve results comparable to LDR-BT with organ sparing. Despite the relatively large patient cohort—the second largest reported to date in this clinical setting—prospective data from larger samples are needed to confirm the role of HDR-BT in penile cancer. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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Review

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16 pages, 3320 KiB  
Review
Comparative Analysis of 60Co and 192Ir Sources in High Dose Rate Brachytherapy for Cervical Cancer
by Aiping Wen, Xianliang Wang, Bingjie Wang, Chuanjun Yan, Jingyue Luo, Pei Wang and Jie Li
Cancers 2022, 14(19), 4749; https://doi.org/10.3390/cancers14194749 - 29 Sep 2022
Cited by 2 | Viewed by 2467
Abstract
High-dose-rate (HDR) brachytherapy (BT) is an essential treatment for cervical cancer, one of the most prevalent gynecological malignant tumors. In HDR BT, high radiation doses can be delivered to the tumor target with the minimum radiation doses to organs at risk. Despite the [...] Read more.
High-dose-rate (HDR) brachytherapy (BT) is an essential treatment for cervical cancer, one of the most prevalent gynecological malignant tumors. In HDR BT, high radiation doses can be delivered to the tumor target with the minimum radiation doses to organs at risk. Despite the wide use of the small HDR 192Ir source, as the technique has improved, the HDR 60Co source, which has the same miniaturized geometry, has also been produced and put into clinical practice. Compared with 192Ir (74 days), 60Co has a longer half-life (5.3 years), which gives it a great economic advantage for developing nations. The aim of the study was to compare 60Co and 192Ir sources for HDR BT in terms of both dosimetry and clinical treatment. The results of reports published on the use of HDR BT for cervical cancer over the past few years as well as our own research show that this treatment is safe and it is feasible to use 60Co as an alternative source. Full article
(This article belongs to the Special Issue Advances in Brachytherapy in the Treatment of Tumors)
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