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Clinical implementation of a new electronic brachytherapy system for skin brachytherapy.

Pons-Llanas O, Ballester-Sánchez R, Celada-Álvarez FJ, Candela-Juan C, García-Martínez T, Llavador-Ros M, Botella-Estrada R, Barker CA, Ballesta A, Tormo-Micó A, Rodríguez S, Perez-Calatayud J - J Contemp Brachytherapy (2014)

Bottom Line: The justification for the hypofractionated regimen is described and compared with others protocols in the literature.We emphasize that these are guidelines, and clinical judgment and experience must always prevail in the care of patients, as with any medical treatment.We conclude that clinical implementation of the Esteya brachytherapy system is simple for patients and providers, and should allow for precise and safe treatment of nonmelanoma skin cancers.

View Article: PubMed Central - PubMed

Affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

ABSTRACT
Although surgery is usually the first-line treatment for nonmelanoma skin cancers, radiotherapy (RT) may be indicated in selected cases. Radiation therapy as primary therapy can result in excellent control rates, cosmetics, and quality of life. Brachytherapy is a radiation treatment modality that offers the most conformal option to patients. A new modality for skin brachytherapy is electronic brachytherapy. This involves the placement of a high dose rate X-ray source directly in a skin applicator close to the skin surface, and therefore combines the benefits of brachytherapy with those of low energy X-ray radiotherapy. The Esteya electronic brachytherapy system is specifically designed for skin surface brachytherapy procedures. The purpose of this manuscript is to describe the clinical implementation of the new Esteya electronic brachytherapy system, which may provide guidance for users of this system. The information covered includes patient selection, treatment planning (depth evaluation and margin determination), patient marking, and setup. The justification for the hypofractionated regimen is described and compared with others protocols in the literature. Quality assurance (QA) aspects including daily testing are also included. We emphasize that these are guidelines, and clinical judgment and experience must always prevail in the care of patients, as with any medical treatment. We conclude that clinical implementation of the Esteya brachytherapy system is simple for patients and providers, and should allow for precise and safe treatment of nonmelanoma skin cancers.

No MeSH data available.


Related in: MedlinePlus

Procedure of the patient marking and set-up. A) The dermatologist marks the lesion with the help of a dermoscope. B) and C) A template (specific for each applicator size) is placed on the patient's lesion and the external diameter of the applicator is drawn on the patient using the grooves of the template. D) The Esteya arm with the specific applicator is finally placed in contact with the patient's skin surface using its different degrees of freedom
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Figure 0001: Procedure of the patient marking and set-up. A) The dermatologist marks the lesion with the help of a dermoscope. B) and C) A template (specific for each applicator size) is placed on the patient's lesion and the external diameter of the applicator is drawn on the patient using the grooves of the template. D) The Esteya arm with the specific applicator is finally placed in contact with the patient's skin surface using its different degrees of freedom

Mentions: the dermatologist contours the GTV lesion on the patient skin with the help of a dermoscope (see Fig. 1A and B),


Clinical implementation of a new electronic brachytherapy system for skin brachytherapy.

Pons-Llanas O, Ballester-Sánchez R, Celada-Álvarez FJ, Candela-Juan C, García-Martínez T, Llavador-Ros M, Botella-Estrada R, Barker CA, Ballesta A, Tormo-Micó A, Rodríguez S, Perez-Calatayud J - J Contemp Brachytherapy (2014)

Procedure of the patient marking and set-up. A) The dermatologist marks the lesion with the help of a dermoscope. B) and C) A template (specific for each applicator size) is placed on the patient's lesion and the external diameter of the applicator is drawn on the patient using the grooves of the template. D) The Esteya arm with the specific applicator is finally placed in contact with the patient's skin surface using its different degrees of freedom
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300364&req=5

Figure 0001: Procedure of the patient marking and set-up. A) The dermatologist marks the lesion with the help of a dermoscope. B) and C) A template (specific for each applicator size) is placed on the patient's lesion and the external diameter of the applicator is drawn on the patient using the grooves of the template. D) The Esteya arm with the specific applicator is finally placed in contact with the patient's skin surface using its different degrees of freedom
Mentions: the dermatologist contours the GTV lesion on the patient skin with the help of a dermoscope (see Fig. 1A and B),

Bottom Line: The justification for the hypofractionated regimen is described and compared with others protocols in the literature.We emphasize that these are guidelines, and clinical judgment and experience must always prevail in the care of patients, as with any medical treatment.We conclude that clinical implementation of the Esteya brachytherapy system is simple for patients and providers, and should allow for precise and safe treatment of nonmelanoma skin cancers.

View Article: PubMed Central - PubMed

Affiliation: Radiotherapy Department, La Fe University and Polytechnic Hospital, Valencia, Spain.

ABSTRACT
Although surgery is usually the first-line treatment for nonmelanoma skin cancers, radiotherapy (RT) may be indicated in selected cases. Radiation therapy as primary therapy can result in excellent control rates, cosmetics, and quality of life. Brachytherapy is a radiation treatment modality that offers the most conformal option to patients. A new modality for skin brachytherapy is electronic brachytherapy. This involves the placement of a high dose rate X-ray source directly in a skin applicator close to the skin surface, and therefore combines the benefits of brachytherapy with those of low energy X-ray radiotherapy. The Esteya electronic brachytherapy system is specifically designed for skin surface brachytherapy procedures. The purpose of this manuscript is to describe the clinical implementation of the new Esteya electronic brachytherapy system, which may provide guidance for users of this system. The information covered includes patient selection, treatment planning (depth evaluation and margin determination), patient marking, and setup. The justification for the hypofractionated regimen is described and compared with others protocols in the literature. Quality assurance (QA) aspects including daily testing are also included. We emphasize that these are guidelines, and clinical judgment and experience must always prevail in the care of patients, as with any medical treatment. We conclude that clinical implementation of the Esteya brachytherapy system is simple for patients and providers, and should allow for precise and safe treatment of nonmelanoma skin cancers.

No MeSH data available.


Related in: MedlinePlus