HDR Brachytherapy

High-dose-rate (HDR) brachytherapy is a technique that uses a relatively intense source of radiation—typically a 10 Curie source made of Iridium 192—to deliver a therapeutic dose of radiation through temporarily placed needles, catheters, or other applicators.

The source is usually attached to or embedded in the end of a source wire or cable. The wire is then driven along catheters into applicators that have previously been placed in the patient. The source dwells in a preplanned position for a preset time before stepping along the catheter and repeating, to build up the required dose distribution.

By varying the position and dwell time, the dose can be neatly sculpted to provide a dose geometry which conforms to the shape of the target. The total dose is typically delivered in a series of two to ten fractions, or treatment sessions.

Varian supplies VariSource™ iX and GammaMedPlus™ iX afterloaders, as well as BrachyVision™ and Vitesse™ treatment planning software and a complete range of applicators and accessories, specially designed for this therapy.

The computer controlled afterloader technique provides significant advantages over older, manual loaded brachytherapy techniques:

  • Prospective treatment plans performed after applicator placement but before radiation delivery potentially eliminate unintended radiation dose, and should eliminate staff dose completely
  • The computer controlled stepping of the source permits exquisite shaping of the dose distribution, to adequately encompass target tissues while sparing as much healthy tissue as possible
  • The rapid dose delivery supports more patient friendly out-patient treatments.

Traditionally, HDR brachytherapy has been used to treat cancers of the cervix and endometrium, bronchus, esophagus, head and neck, and soft tissue sarcomas. More recently, the technology has been successfully applied to prostate and breast cancers.

 

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