Johannesenperry2799

16% compared to TG-43, and near-maximum dose decreased by 8.18% (

= 0.000), mean D

dose to CTV-HDR_evl, and mean D

dose was lesser by 6.25% (

= 0.000) and 10.82% (

= 0.000), respectively, compared to TG-43. Heart D

showed significant results, whereas D

(cGy) revealed very significant difference. A 5 mm thick skin contour showed statistically significant results (

= 0.000) for V

and V

.

The presented data showed how Acuros

BV, algorithm-based calculation in scar boost irradiation of breast, accounting for a mass density of the medium and scatter condition, considered actual dose prediction in a medium.

The presented data showed how Acuros® BV, algorithm-based calculation in scar boost irradiation of breast, accounting for a mass density of the medium and scatter condition, considered actual dose prediction in a medium.

To dosimetrically compare high-dose-rate interstitial brachytherapy (HDR-BT) with volumetric-modulated arc therapy (VMAT) for tumor bed boost, following breast conservative treatment.

50 patients with early-stage breast cancer who underwent breast conservation surgery, followed by either HDR-BT (

= 25) of 15 Gy in 6 fractions over a period of 3 days, or VMAT dose of 16 Gy in 8 fractions (

= 25) for tumor bed boost, were retrospectively reviewed. All patients received whole breast irradiation of 46 Gy in 23 fractions. Dosimetric parameters for organs at risk (OARs), including ipsilateral and contralateral lungs, heart, contralateral breast, skin, and ribs, were evaluated with the help of dose-volume histograms (DVH).

Heart sparing was similar in both modalities (left-sided breast irradiation, HDR-BT D

20.5% vs. VMAT 30.2%,

-value = 0.243; right-sided breast irradiation, D

6.5% vs. 4.4%,

-value = 0.165). Left-sided cases received higher dose to heart compared to right-sided patients. Interstitial brachytherapy resulted in significantly less dose to contralateral breast (D

4.3% vs. 9.6%,

-value < 0.0001), ipsilateral lung (D

27.6% vs. Selleck Mizoribine 73.2%,

-value < 0.0001), contralateral lung (D

4.2% vs. 14.5%,

-value < 0.0001), ribs (D

24.1% vs. 41.2%,

-value < 0.0001), and skin (D

77.3% vs. 95%,

-value < 0.0001).

HDR-BT-based tumor bed boost irradiation results in significantly lower doses to most organs at risk with similar heart sparing compared to VMAT.

HDR-BT-based tumor bed boost irradiation results in significantly lower doses to most organs at risk with similar heart sparing compared to VMAT.

American Brachytherapy Society (ABS) guidelines recommend using a 3-5 cm active length (AL) when treating vaginal cuff (VC) in adjuvant setting of endometrial cancer (EC). The purpose of this study was to evaluate local control and toxicity, using an AL of 1 or 2 cm and immobilization with a traditional table-mounted (stand) or patient-mounted (suspenders) device.

Between 2005 and 2019, 247 patients with EC were treated with adjuvant high-dose-rate vaginal cuff (HDR-VC) brachytherapy with or without external beam radiation (EBRT). Treatment was prescribed to a 0.5 cm depth, with an AL of 1 or 2 cm, using stand or suspenders. VC boost after EBRT was typically administered with 2 fractions of 5.5 Gy, while VC brachytherapy alone was typically applied with 3 fractions of 7 Gy or 5 fractions of 5.5 Gy.

The combination of suspender immobilization and an AL of 2 cm (

= 126, 51%) resulted in 5-year local control of 100%. An AL of 2 cm compared to 1 cm correlated with better local control (99.1% vs. 88.5%,

= 0.0479). Regarding immobilization, suspenders correlated with improved local control compared to stand (100% vs. 86.7%,

= 0.0038). Immobilization technique was significantly correlated with AL (

< 0.0001). Only 5 (2.0%) patients experienced grade ≥ 3 toxicity, all of whom received EBRT.

In the present series, an AL of 2 cm provided excellent local control, while 1 cm was inadequate. Suspender immobilization was a practical alternative to stand immobilization in HDR brachytherapy of the vaginal cuff.

In the present series, an AL of 2 cm provided excellent local control, while 1 cm was inadequate. Suspender immobilization was a practical alternative to stand immobilization in HDR brachytherapy of the vaginal cuff.

The aim of the study was to determine the feasibility of interstitial brachytherapy under non-anesthetist-administered moderate sedation, to identify factors influencing the insertion, and the total procedural time.

A total of 47 insertions with hybrid intracavitary and interstitial applicators were performed in 23 patients from March 2017 to March 2020. Moderate sedation was achieved with intravenous midazolam and fentanyl administered by non-anesthetist. Insertion time and procedural time was recorded. Univariate and multivariate analysis were performed to evaluate the impact of different factors on insertion and procedural time.

A total of 238 needles (range, 2-8 per insertion) were implanted, with an average insertion depth of 30 mm (range, 20-40 mm). The mean doses for midazolam and fentanyl were 3 mg (standard deviation [SD] = 1) and 53.3 mcg (SD = 23.9) per insertion, respectively. The median insertion time was 30 minutes (interquartile range [IQR] = 22-40), and the median total procedural time was 4.3 hours (IQR = 3.6-5.2). First time insertion, insertions performed before 2019, and higher midazolam dose were associated with significantly longer insertion time, whereas longer insertion time, MRI-based planning, and insertions performed before 2019 were associated with significantly longer total procedural time.

Outpatient interstitial brachytherapy with non-anesthetist-administered sedation is achievable and well-tolerated. This method may significantly lessen the burden on hospital resources and has the potential to be cost-effective.

Outpatient interstitial brachytherapy with non-anesthetist-administered sedation is achievable and well-tolerated. This method may significantly lessen the burden on hospital resources and has the potential to be cost-effective.

The use of vaginal immobilization balloons placed into the vagina for immobilization of tandem and ovoid (T+O) applicator during high-dose-rate (HDR) brachytherapy delivery has been used at our institution, and seems to have improved our patient comfort, decreased procedure time, and minimized applicator misplacement. We aimed to show that these balloons, while originally marketed for single-day use, are safe and maintain applicator positioning/dosimetry when left

overnight for treatment delivery on sequential days.

Forty-two paired computed tomography (CT) scans from thirteen patients who underwent T+O HDR treatments on sequential days with vaginal immobilization balloons

overnight were retrospectively compared to calculate mean change of balloon volumes and balloon/T+O distance to bony landmarks. Dosimetric planning was retroactively performed on day 2 using CT scan of each pair, and the change in estimated radiation delivery to the bladder and rectum was compared.

No statistically significant o for additional HDR T+O treatments on sequential days, is safe and provides stable dosimetry.

To investigate the accuracy and dosimetry of 3D-printing non-coplanar template (3D-PNCT)-assisted computed tomography (CT)-guided iodine-125 seed implantation (

I-SI) for recurrent chest wall cancer (rCWC).

This was a retrospective study of 19 patients with 22 rCWC treated with 3D-PNCT-assisted CT-guided

I-SI, from Mar 2017 to Mar 2020 in our institute.

Mean needle entrance deviation was 4.50 ±2.70 mm, mean angular deviation was 3.40 ±3.10 degrees, and mean depth deviation was 5.20 ±5.20 mm. No significant difference was found for dosimetric parameters (except conformity index) between pre-plan and post-plan; D

, D

, V

, V

, and V

were 157.74 ±24.23 and 151.71 ±33.62 (

= 0.228), 85.36 ±34.09 and 70.46 ±23.48 (

= 0.067), 0.93 ±0.04 and 0.90 ±0.07 (

= 0.068), 0.64 ±0.16 and 0.64 ±0.16 (

= 0.984), and 0.35 ±0.17 and 0.37 ±0.18 (

= 0.382) for pre-plan and post-plan, respectively. Conformity index, external index, and homogeneity index were 0.57 ±0.16 and 0.52 ±0.15 (

= 0.007), 0.73 ±0.55 and 0.79 ±0.53 (

= 0.096), and 0.31 ±0.15 and 0.30 ±0.14 (

= 0.504) for pre-plan and post-plan, respectively. Median follow-up time was 8 months (range, 3-30 months). Complete response was observed in 4/22 (18.1%), partial response in 13/22 (59.1%), stable disease in 4/22 (18.1%), and progression disease in 1/22 (4.5%) of the cancers. Among patients with pain before

I-SI, pain relief rate was 87.5% (7/8). No peri-operative complications of more than grade 2 were observed.

3D-PNCT-assisted CT-guided

I-SI may be safe and feasible as palliative therapy for non-surgical candidates and painful patients with rCWC.

3D-PNCT-assisted CT-guided 125I-SI may be safe and feasible as palliative therapy for non-surgical candidates and painful patients with rCWC.

To examine clinical outcomes and quality of life of patients with anal squamous cell carcinoma treated with interstitial pulsed-dose-rate brachytherapy (PDR-BT) with a boost to residual tumor after external radiotherapy.

Medical records of patients receiving a brachytherapy boost after radiotherapy for anal squamous cell carcinoma in our Institute between 2008 and 2019 were retrospectively reviewed. After receiving pelvic irradiation ± concurrent chemotherapy, patients received PDR-BT boost to residual tumor, in order to deliver a minimal total dose of 60 Gy. Patients' outcomes were analyzed, with primary focus on local control, sphincter preservation, morbidity, and quality of life.

A total of 42 patients were identified, included 24, 13, and 5 patients with I, II, and III tumor stages, respectively. Median brachytherapy (BT) dose was 20 Gy (range, 10-30 Gy). Median dose per pulse was 42 cGy (range, 37.5-50 cGy). With median follow-up of 60.4 months (range, 5.4-127.4 months), estimated local control and colostomy-free survival rates at 5 years were both 88.7% (95% CI 67.4-96.4%). The largest axis of residual lesion after external beam radiation therapy (EBRT) and poor tumor shrinkage were associated with more frequent relapses (

= 0.02 and

= 0.007, respectively). Out of 40 patients with more than 6 months follow-up, only one experienced severe delayed toxicity (fecal incontinence). Health quality perception was very good or good in 20 of 22 (91%) patients, according to their replies of quality-of-life surveys. A total dose ≥ 63 Gy was associated with higher number of anorectal grade 1+ toxicities (

= 1.5 vs.

= 0.61,

= 0.02).

In this cohort of 42 patients with mainly I and II tumor stages, PDR-BT boost allowed for local control in 88.7% of patients, with only one grade 3 anorectal toxicity.

In this cohort of 42 patients with mainly I and II tumor stages, PDR-BT boost allowed for local control in 88.7% of patients, with only one grade 3 anorectal toxicity.

Prostate cancer with median lobe hyperplasia (MLH) is a relative contraindication for permanent prostate brachytherapy (PPB) because of an increased risk of post-implant dysuria and technical difficulties associated with achieving stability while implanting within the intravesical tissue. We examined treatment outcome, seed migration, and urination disorders after treatment in MLH patients in order to determine to what degree MLH implants could be stabilized.

Between March 2007 and December 2016, 32 patients had MLH identified radiologically on magnetic resonance imaging, and 193 patients did not have MLH (non-MLH). All patients were treated with loose seeds. In this study, seed migration was defined as a seed distant from the target (≥ 1.5 cm) and/or with no dosimetric contribution to the target. The MLH patients were divided into 2 MLH groups of mild (< 10 mm) and severe (≥ 10 mm) MLH by measuring the distance between the posterior transitional zone and the prostatic tissue protruding into the bladder.