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Application of Brachytherapy in Clinical Practice

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426).

Deadline for manuscript submissions: closed (30 January 2023) | Viewed by 8753

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Dr. Elisa Placidi

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Guest Editor

UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
Interests: interventional radiotherapy; brachytherapy; TPS algorithms; dosimetry; planning techniques
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Ángeles Rovirosa

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Fonaments Clinics Dpt, Faculty of Medicine, Universitat de Barcelon, Barcelona, Spain
Interests: brachytherapy techniques; gynecological oncology; educational gynecological oncology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Brachytherapy (or interventional radiotherapy) is a well-established radiotherapy technique with a long history of experience and successful applications. In recent years, there have been a lot of innovations in radiotherapy which included the introduction of hybrid machines, IGRT techniques, and high-technology improvements to treat tumors with a very high accuracy, limiting the doses to the healthy tissues. Nevertheless, brachytherapy has not been considered obsolete because of its peculiarities. The characteristic steep dose gradients obtained by brachytherapy are unique and have multiple clinical applications. Therefore, brachytherapy cannot be considered an old-fashioned technique, and further improvements deserve to be further investigated.

This Special Issue of the Journal of Personalized Medicine focuses on the current state of interventional radiotherapy with particular attention to the clinical practice and the latest findings in the field. It will be an outlook to the innovations of brachytherapy to focus on the features mostly required in present and future clinical practice. This issue invites leading professionals in the field to share, discuss, and integrate clinical practice solutions.

Therefore, we are particularly soliciting papers that feature the most exciting advances in the field of brachytherapy in clinical practice.

Dr. Elisa Placidi
Prof. Dr. Ángeles Rovirosa
Guest Editors

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. Journal of Personalized Medicine is an international peer-reviewed open access monthly 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 2600 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

interventional radiotherapy
brachytherapy
dosimetric optimization
treatment planning
multi-modal imaging
biological planning
multidisciplinary procedures
LDR/HDR/PDR brachytherapy
ocular brachytherapy
combined EBRT + brachytherapy

Published Papers (4 papers)

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Research

10 pages, 1480 KiB

Open AccessArticle

ORIFICE (Interventional Radiotherapy for Face Aesthetic Preservation) Study: Results of Interdisciplinary Assessment of Interstitial Interventional Radiotherapy (Brachytherapy) for Periorificial Face Cancer

by Luca Tagliaferri, Ilaria Giarrizzo, Bruno Fionda, Mario Rigante, Monica Maria Pagliara, Calogero Casà, Claudio Parrilla, Valentina Lancellotta, Elisa Placidi, Alessandra Salvati, Gabriella Macchia, Stefano Gentileschi, Maria Antonietta Blasi, Alessio Giuseppe Morganti, Francesco Bussu, Ketty Peris, Gaetano Paludetti and Vincenzo Valentini

J. Pers. Med. 2022, 12(7), 1038; https://doi.org/10.3390/jpm12071038 - 24 Jun 2022

Cited by 5 | Viewed by 1710

Abstract

(1) Background: Periorificial face cancer (PFC), defined as both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) arising around the eyelids, the nose vestibule and the lips, has very high incidence rates worldwide. The aim of our retrospective analysis, focusing on local control (LC) and patients’ degree of satisfaction with the cosmetic outcome, is to present the results of a single institutional series of patients affected by PFC and treated by interventional radiotherapy (brachytherapy–IRT). (2) Methods: We retrospectively evaluated patients affected by PFC who were treated at our Interventional Oncology Center (IOC) with interstitial IRT from 2012 to 2021 with doses and volumes specific for each subsite considered. (3) Results: We report the results of 40 patients affected by PFC and treated by HDR interstitial IRT. The median follow-up was 24 months. The actuarial 3-year LC was 94%. Regarding patients’ satisfaction, we found that 93% of patients were satisfied and only 7% of patients were not completely satisfied with the final cosmetic result. (4) Conclusions: Interstitial HDR IRT could be an effective therapeutic option providing adequate disease control and preventing potentially disfiguring surgical approaches. More numerous and standardized studies are warranted to confirm the available evidence. Full article

(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice)

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16 pages, 5195 KiB

Open AccessArticle

Modified Geometry of ¹⁰⁶Ru Asymmetric Eye Plaques to Improve Dosimetric Calculations in Ophthalmic Brachytherapy

by Héctor Miras, José Antonio Terrón, Alejandro Bertolet and Antonio Leal

J. Pers. Med. 2022, 12(5), 723; https://doi.org/10.3390/jpm12050723 - 29 Apr 2022

Cited by 1 | Viewed by 1673

Abstract

Ru/Rh asymmetric plaques for ophthalmic brachytherapy have special geometric designs with a cutout intended to prevent irradiation of critical ocular structures proximal to the tumor. In this work, we present new geometric models for PENELOPE+PenEasy Monte Carlo simulations of these applicators, differing from the vendor-reported geometry, that better match their real geometry to assess their dosimetric impact. Simulation results were benchmarked to experimental dosimetric data from radiochromic film measurements, data provided by the manufacturer in the calibration certificates, and other experimental results published in the literature, obtaining, in all cases, better agreement with the modified geometries. The clinical impact of the new geometric models was evaluated by simulating real clinical cases using patient-specific eye models. The cases calculated using the modified geometries presented higher doses to the critical structures proximal to the cutout region. The modified geometric models presented in this work provide a more accurate representation of the asymmetric plaques, greatly improving the agreement between Monte Carlo calculations and experimental measurements. Lack of consideration of accurate geometric models has been shown to be translated into notable increases in dose to organs at risk in clinical cases. Full article

(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice)

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15 pages, 16795 KiB

Open AccessArticle

Long-Term Comparative Study on the Local Tumour Control of Different Ablation Technologies in Primary and Secondary Liver Malignancies

by Attila Kovács, Peter Bischoff, Hathal Haddad, Willi Zhou, Susanne Temming, Andreas Schäfer, Hannah Spallek, Lucas Kaupe, György Kovács and Michael Pinkawa

J. Pers. Med. 2022, 12(3), 430; https://doi.org/10.3390/jpm12030430 - 09 Mar 2022

Cited by 6 | Viewed by 2052

Abstract

Purpose: To evaluate local tumour control (LTC) by local ablation techniques (LAT) in liver malignancies. Materials and methods: In patients treated with LAT between January 2013 and October 2020 target lesions were characterised by histology, dimensions in three spatial axes, volume, vascularisation and challenging (CL) location. LAT used were: Radiofrequency Ablation (RFA), Microwave Ablation (MWA), Cryoablation (CRYO), Electrochemotherapy (ECT), and Interstitial Brachytherapy (IBT). Results: 211 LAT were performed in 155 patients. Mean follow-up including MRI for all patients was 11 months. Lesions treated with ECT and IBT were significantly larger and significantly more often located in CL in comparison to RFA, MWA and CRYO. Best LTC (all data for 12 months are given below) resulted after RFA (93%), followed by ECT (81%), CRYO (70%), IBT (68%) and MWA (61%), and further, entity-related for HCC (93%), followed by CRC (83%) and BrC (72%), without statistically significant differences. LTC in hypovascular lesions was worse (64%), followed by intermediate (82% p = 0.01) and hypervascular lesions (92% p = 0.07). Neither diameter (<3 cm: 81%/3–6 cm: 74%/>6 cm: 70%), nor volume (<10 cm³: 80%/10–20 cm³: 86%/>20 cm³: 67%), nor CL (75% in CL vs. 80% in non CL) had a significant impact on LTC. In CL, best LTC resulted after ECT (76%) and IBT (76%). Conclusion: With suitable LAT, similarly good local tumour control can be achieved regardless of lesion size and location of the target. Full article

(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice)

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12 pages, 1587 KiB

Open AccessArticle

Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study

by Yi Chen, Jinzhao Dai, Yuliang Jiang, Zhe Ji, Ping Jiang, Haitao Sun, Fei Xu and Junjie Wang

J. Pers. Med. 2021, 11(9), 839; https://doi.org/10.3390/jpm11090839 - 26 Aug 2021

Cited by 7 | Viewed by 2374

Abstract

The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control. Full article

(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice)

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