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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

Esteya unit with the QA tool provided by Elekta, which is composed of 26 diodes placed in two parallel planes in order to check constancy of output, flatness and PDD
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Figure 0004: Esteya unit with the QA tool provided by Elekta, which is composed of 26 diodes placed in two parallel planes in order to check constancy of output, flatness and PDD

Mentions: According to the current recommendation of the European Society for Therapeutic Radiology and Oncology (ESTRO) [32], each high dose rate unit needs a quality assurance (QA) program that guarantees the proper delivery of the selected radiation dose. For the Esteya unit, on each treatment day it is mandatory to perform a QA before the first patient can be treated. The manufacturing company provides a specially designed QA tool with the system that is connected to the exit of the X-ray tube (see Fig. 4). This tool is composed of 26 diodes placed in two parallel planes [33], which are used to evaluate the output, flatness, and percentage dose depth curve at the same time. After the QA plan has been irradiated (this QA program takes less than 3 minutes), the equipment console automatically shows the comparison with the reference values. Only if results are below an established tolerance, the system allows patients to be treated. Furthermore, following the recommendations, the light indicators, emergency buttons, and interlocks need to be tested by the user every day.


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)

Esteya unit with the QA tool provided by Elekta, which is composed of 26 diodes placed in two parallel planes in order to check constancy of output, flatness and PDD
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0004: Esteya unit with the QA tool provided by Elekta, which is composed of 26 diodes placed in two parallel planes in order to check constancy of output, flatness and PDD
Mentions: According to the current recommendation of the European Society for Therapeutic Radiology and Oncology (ESTRO) [32], each high dose rate unit needs a quality assurance (QA) program that guarantees the proper delivery of the selected radiation dose. For the Esteya unit, on each treatment day it is mandatory to perform a QA before the first patient can be treated. The manufacturing company provides a specially designed QA tool with the system that is connected to the exit of the X-ray tube (see Fig. 4). This tool is composed of 26 diodes placed in two parallel planes [33], which are used to evaluate the output, flatness, and percentage dose depth curve at the same time. After the QA plan has been irradiated (this QA program takes less than 3 minutes), the equipment console automatically shows the comparison with the reference values. Only if results are below an established tolerance, the system allows patients to be treated. Furthermore, following the recommendations, the light indicators, emergency buttons, and interlocks need to be tested by the user every day.

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