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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

Images illustrating different set-ups of the patient and the Esteya arm
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Figure 0003: Images illustrating different set-ups of the patient and the Esteya arm

Mentions: The Esteya arm has several degrees of freedom in order to place the applicator in full contact with the surface of the patient, for almost any patient position. This is illustrated in Figure 3, which shows the set-up for different patients. The patient position may change slightly from fraction to fraction. However, since the arm is moved manually, the patient position reproducibility is not a really important issue, as long as the applicator exit surface is always placed in full contact with the lesion.


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)

Images illustrating different set-ups of the patient and the Esteya arm
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0003: Images illustrating different set-ups of the patient and the Esteya arm
Mentions: The Esteya arm has several degrees of freedom in order to place the applicator in full contact with the surface of the patient, for almost any patient position. This is illustrated in Figure 3, which shows the set-up for different patients. The patient position may change slightly from fraction to fraction. However, since the arm is moved manually, the patient position reproducibility is not a really important issue, as long as the applicator exit surface is always placed in full contact with the lesion.

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