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Brachytherapy is a form of radiation therapy that places a small radioactive source in or near the tumor. This method protects surrounding healthy cells from radiation exposure because the radiation is delivered directly to the tumor, avoiding the surrounding tissue. With high dose rate (HDR) brachytherapy, a high does of radiation is delivered to the tumor in a very short period of time.
The steps for a typical HDR procedure include:
1) Inserting the catheter
The type of catheter the patient requires is based on location, tumor extent and other factors. This step is usually done in endoscopy or the operating room.
2) Simulation and treatment planning
After the catheter has been placed, either CT or X-ray films are taken to determine the exact location of the catheter in the body and the relationship to adjacent organs. The radiation oncologist reviews the films and makes final adjustments to the catheter if necessary. Next, the radiation physicist or dosimetrist customizes the treatment plan (using the films) to target the tumor while minimizing the doses to the nearby normal tissues. The treatment plan is entered into a computer and then transferred to the HDR remote afterloader, a machine that holds the radioactive sources. This step is completed in the radiation oncology department.
The ends of the catheters that protrude outside the body are connected to transfer tubes which are then connected to the afterloader. The programmed instructions tell the afterloader where to direct the radiation and how long it will stay in each area. The patient is alone in the treatment room while the treatment is being given, but therapists and nurses are continually monitoring the patient through an intercom and closed circuit TV monitors. The time the radiation spends in the catheter is about 10 to 15 minutes.
4) Catheter removal
After all of the treatment(s) have been given, the catheter is removed. Most HDR patients receive several treatments over the course of a few days.
HDR brachytherapy is used alone or in combination with other treatment modalities, such as traditional external beam radiation.
The HDR center uses an Integrated Brachytherapy Unit (IBU), which brings together all aspects of HDR brachytherapy treatment in one location. A rotating X-ray system takes images from all possible directions without moving the patient. These X-rays provide mages which allow the cancer specialist to target the tumor precisely when planning and conducting the procedure.
Using the IBU reduces the risk of possible movement of the catheter during transportation from one department to the other and minimizes the amount of time necessary to complete the procedure and makes the treatment more comfortable. These benefits are significant for HDR brachytherapy patients, who often require several treatments.
Many types of cancer can be treated at the HDR Center, including breast, lung, gynecologic, prostate, brain and esophageal cancers.
For more information, call 704-384-4188.