Rationality and Evidence of Pre-Prepared Treatment Plan in Oesophageal HDR Brachytherapy

Authors: Jim Meng, Mammo Yewondwossen

Abstract:

As a part of routine oesophageal HDR Brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms before the 90-minute brachytherapy procedure complete, and the treatment may need to be aborted. A pre-prepared plan generated before patient’s sedation may reduce the brachytherapy procedure time by 40 minutes. This paper reports rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirms that pre-prepared plans would be acceptable for all reviewed patients. The rationality is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. The argument holds for endobronchial HDR brachytherapy too. With the above evidence, pre-prepared plans have been used for all oesophageal and endobronchial HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1335880

References:

[1] A. D. Flores, "Cancer of the oesophagus: Treatment strategies & results of a Canadian randomised study”, 7th International Brachytherapy Working Conference, Baltimore/Washington, USA, 6-8 September 1992.
[2] Kolkman-Deurloo IK, Nuyttens JJ, Hanssens PE, Levendag PC, "Intraoperative HDR brachytherapy for rectal cancer using a flexible intraoperative template: standard plans versus individual planning”, Radiother Oncol. 70(1):75-9. (2004).
[3] Gary A. Ezzell, "Limitations of the straight-line assumption for endobronchial HDR brachytherapy treatments”, Med. Phys. 27, 151 (2000).
[4] Nucletron Corp, Waardgelder 1, 3905TH, PO BOX 930, 3900 AX Veenendaal, Netherlands.