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Application of Brachytherapy in Clinical Practice: 2nd Edition
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Application of Brachytherapy in Clinical Practice: 2nd Edition

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Clinical Medicine, Cell, and Organism Physiology".

Deadline for manuscript submissions: closed (20 January 2025) | Viewed by 5968

Special Issue Editors

Dr. Elisa Placidi

E-Mail Website
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
Dr. Àngeles Rovirosa

E-Mail Website
Guest Editor
Fonaments Clinics Department, Faculty of Medicine, Universitat de Barcelon, Barcelona, Spain
Interests: interventional radiotherapy; brachytherapy techniques; gynecological oncology; educational gynecology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Interventional radiotherapy (brachytherapy) started after the discovery of radium by Maria Slodowoska Curie, and, at present, has clear indications for treatment in almost tumour sites. The present Special Issue is one of the few publications dedicated to interventional radiotherapy in Europe.

The aim of this Special Issue is to present all the relevant clinical aspects of brachytherapy in all the tumour sites in a review or article format, considering future perspectives. To this end, clinical and medical brachytherapists work together with very specialised medical physicists, who are indispensable for the techniques’ evolution.

The submission of innovative clinical works in clinical practice and in physics, considering all the tumour sites is encouraged. Contributions exploring biological biomarkers and omics’ brachytherapy, as well Montecarlo aspects in vivo dosimetry, among others, are welcome.

We are soliciting reviews and original articles, and look forward to receiving your contributions.

Dr. Elisa Placidi
Dr. Àngeles 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
  • medical brachytherapy
  • physics in brachytherapy
  • clinical applications
  • algorithms in interventional radiotherapy

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Published Papers (4 papers)

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13 pages, 1498 KiB  
Article
Safety and Efficacy of Brachytherapy in Inoperable Endometrial Cancer
by Ricarda Merten, Vratislav Strnad, Claudia Schweizer, Michael Lotter, Stephan Kreppner, Rainer Fietkau, Philipp Schubert and Andre Karius
J. Pers. Med. 2024, 14(12), 1138; https://doi.org/10.3390/jpm14121138 - 3 Dec 2024
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Abstract
Background/Objectives: 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. Methods: Between 1990 and 2019, 18 patients [...] Read more.
Background/Objectives: 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. Methods: Between 1990 and 2019, 18 patients with inoperable EC in stage FIGO I–IV were treated with intracavitary brachytherapy using the “Heyman Packing technique”. BT was performed either as sole PDR- or HDR-brachytherapy with a median cumulative dose up to 60.0 Gy (67.9 Gy EQD2 α/β = 3Gy) and 34.0 Gy (75.6 Gy EQD2 α/β = 3Gy), respectively. Results: The median follow-up was 46 months (6–219). The mean age was 71 years. The 5-year cumulative local recurrence rate (CLRR) for the whole cohort was 27.3%. The 5-year overall survival (OS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) were 51%, 79%, and 69%. The 5-year DFS for low-, intermediate-, and high-risk EC was 89%, 50%, and 44% (p = 0.51). No significant difference in DFS was observed in patients over 70 (p = 0.526). No late side effects of grade > 1 were documented. Conclusions: Brachytherapy for inoperable EC is a safe and effective treatment option, offering good local control and OS with minimal toxicity. Moreover, brachytherapy effectively controls hemoglobin-relevant bleeding. Therefore, BT should be considered a viable alternative to non-curative treatment strategies in gynecological multidisciplinary conferences. Full article
(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice: 2nd Edition)
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11 pages, 1197 KiB  
Article
Outcomes of I-125 Low-Dose-Rate Brachytherapy in Patients with Localized Prostate Cancer: A Comprehensive Analysis from a Specialized Tertiary Referral Center
by Philipp Schubert, Vratislav Strnad, Daniel Höfler, Claudia Schweizer, Florian Putz, Michael Lotter, Stephan Kreppner, Andre Karius, Rainer Fietkau and Ricarda Merten
J. Pers. Med. 2024, 14(8), 882; https://doi.org/10.3390/jpm14080882 - 21 Aug 2024
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Abstract
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 [...] Read more.
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. The analysis focused on biochemical recurrence rates (BRFS), overall survival (OS), cumulative local recurrence rate (CLRR), and the incidence of acute and late toxicities. Patient-reported quality of life measures were also evaluated to provide a holistic view on the treatment’s impact. The median follow-up period was 46 months. CLRR was 3.3% (4/119), five-year BRFS was 87%, and the five-year OS rate was 95%. Dysuria was the most common acute urinary toxicity, reported in 26.0% of patients as grade 1 and 13.4% as grade 2. As a late side effect, 12.6% of patients experienced mild dysuria. Sexual dysfunction persisted in 6.7% of patients as grade 1, 7.5% as grade 2, and 10.0% as grade 3. LDR brachytherapy in patients with prostate cancer is an effective treatment, with favorable clinical outcomes and manageable toxicity. The low CLRR and high OS rates, as well as low incidence of severe side effects, support the continued use of LDR brachytherapy as a primary treatment modality for localized prostate cancer. Full article
(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice: 2nd Edition)
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15 pages, 6019 KiB  
Article
Characterization of Plastic Scintillator Detector for In Vivo Dosimetry in Gynecologic Brachytherapy
by Antonio Herreros, José Pérez-Calatayud, Facundo Ballester, Rosa Abellana, Joana Neves, Joana Melo, Luis Moutinho, Jordi Tarrats-Rosell, Sergi Serrano-Rueda, Luca Tagliaferri, Elisa Placidi and Angeles Rovirosa
J. Pers. Med. 2024, 14(3), 321; https://doi.org/10.3390/jpm14030321 - 20 Mar 2024
Cited by 1 | Viewed by 1668
Abstract
(1) Background: High dose gradients and manual steps in brachytherapy treatment procedures can lead to dose errors which make the use of in vivo dosimetry (IVD) highly recommended for verifying brachytherapy treatments. A new procedure was presented to obtain a calibration factor which [...] Read more.
(1) Background: High dose gradients and manual steps in brachytherapy treatment procedures can lead to dose errors which make the use of in vivo dosimetry (IVD) highly recommended for verifying brachytherapy treatments. A new procedure was presented to obtain a calibration factor which allows fast and robust calibration of plastic scintillation detector (PSD) probes for the geometry of a compact phantom using Monte Carlo simulations. Additionally, characterization of PSD energy, angular, and temperature dependences was performed. (2) Methods: PENELOPE/PenEasy code was used to obtain the calibration factor. To characterize the energy dependence of the PSD, the signal was measured at different radial and transversal distances. The sensitivity to the angular position was characterized in axial and azimuthal planes. (3) Results: The calibration factor obtained allows for an absorbed dose to water determination in full scatter conditions from ionization measured in a mini polymethylmethacrylate (PMMA) phantom. The energy dependence of the PSD along the radial distances obtained was (2.3 ± 2.1)% (k = 1). The azimuthal angular dependence measured was (2.6 ± 3.4)% (k = 1). The PSD response decreased by (0.19 ± 0.02)%/°C with increasing detector probe temperature. (4) Conclusions: The energy, angular, and temperature dependence of a PSD is compatible with IVD. Full article
(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice: 2nd Edition)
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19 pages, 537 KiB  
Systematic Review
Local Control, Survival, and Toxicity Outcomes with High-Dose-Rate Peri-Operative Interventional Radiotherapy (Brachytherapy) in Head and Neck Cancers: A Systematic Review
by Warren Bacorro, Bruno Fionda, Tamer Soror, Francesco Bussu, György Kovács and Luca Tagliaferri
J. Pers. Med. 2024, 14(8), 853; https://doi.org/10.3390/jpm14080853 - 11 Aug 2024
Viewed by 2039
Abstract
Background. Peri-operative interventional radiotherapy (POIRT) entails tumor resection, catheter implantation in the same surgery, and irradiation within the peri-operative period. It allows for maximal tumor burden reduction, better tumor bed identification, more flexible implant geometry, highly conformal irradiation, and treatment delay minimization. We [...] Read more.
Background. Peri-operative interventional radiotherapy (POIRT) entails tumor resection, catheter implantation in the same surgery, and irradiation within the peri-operative period. It allows for maximal tumor burden reduction, better tumor bed identification, more flexible implant geometry, highly conformal irradiation, and treatment delay minimization. We reviewed the published local control, survival, toxicity, and quality of life (QOL) outcomes with POIRT for head and neck cancers (HNCs) in primary and re-irradiation settings. Materials and Methods. A systematic search of PubMed, Scopus, Science Direct, and other databases, supplemented by bibliography scanning and hand-searching, yielded 107 titles. Fifteen unique articles were eligible, five of which were merged with more updated studies. Of the ten remaining studies, four reported on primary POIRT, and seven reported on reirradiation POIRT. Given data heterogeneity, only qualitative synthesis was performed. Results. Primary POIRT in early tongue cancer results in 6-year recurrence-free (RFS) and overall survival (OS) of 92% for both; in advanced HNCs, the 9-year RFS and OS rates are 52% and 55%. Grade 1–2 toxicity is very common; grade 3–4 toxicity is rare, but grade 5 toxicity has been reported. POIRT re-irradiation for recurrent HNCs results in 5y RFS and OS rates of 37–55% and 17–50%; better outcomes are achieved with gross total resection (GTR). QOL data are lacking. Conclusions. Primary POIRT is safe and effective in early tongue cancers; its use in other HNC sites, especially in advanced disease, requires careful consideration. Re-irradiation POIRT is most effective and safe when combined with GTR; toxicity is significant and may be limited by careful case selection, implant planning and execution, use of smaller fraction sizes, and adherence to homogeneity constraints. Study Registration Number. PROSPERO Registry Number CRD42024548294. Full article
(This article belongs to the Special Issue Application of Brachytherapy in Clinical Practice: 2nd Edition)
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