Brachytherapy to Treat Cancers

Brachytherapy (brachy means 'short' in Greek) is a form of radiation therapy in cancer where the radiation source is placed in or around the area to be treated. Brachytherapy is usually part of the overall therapy that usually includes external beam radiation therapy.





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Types and Clinical Applications of Brachytherapy

The following are the main methods of brachytherapy applications :

1. Interstitial brachytherapy – In this form of treatment, the radioactive source is placed in the area to be treated. The placement of the radioactive source follows certain rules to ensure uniform distribution of dose within the treated area. This form of brachytherapy is usually used in cancer of the prostate, head and neck cancer and occasionally soft tissue sarcoma.

2. Intracavitary brachytherapy – Here the radioactive source is placed in a cavity in close proximity to the treated area. Examples of this include cancer of the cervix, endometrium and also nasopharyngeal carcinoma.

3. Intraluminal brachytherapy – The radioactive source is placed in a lumen or cavity where the cancer is. Examples of this include oesophageal and lung cancer and some cholangio-carcinomas.

Delivery

The radioactive source used determines the dose rate – low or high dose rate. Low dose rate brachytherapy usually takes a few days to deliver the desired dose and generally requires admission into a specially constructed and shielded room.

Low dose rate brachytherapy has been largely superseded by high dose rate brachytherapy where only a few minutes is needed to deliver the required dose. The high dose rate brachytherapy sources used include Iridium-192 or Cobalt-60.

Applicators

When delivering brachytherapy, applicators or flexi tubes are placed in the cavity or tumour. Only when the placement is ideal will the radioactive source be placed in the applicator or plastic tubes to deliver the radiation.

The placement of the radioactive source can be done either manually (manual after-loading) or under remote control (remote after-loading). This remote after-loading is the method of choice as it significantly reduces the exposure of radiation to the staff handling the procedure.

More info on BRACHYTHERAPY HERE.






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