Brachytherapy
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Brachytherapy
Brachytherapy, also called as internal radiation, is a treatment
achieved by placing radioactive material directly into the tumor or very close to it
Brachytherapy uses ionizing radiation wherein small encapsulated radioactive sources are arranged in geometric fashion in and around the tumor
Brachytherapy is derived from the greek letter ‘Brachys’ , meaning short distance, as this treatment is able to deliver high doses of radiation over short distance
This internal radiation is generally used along with external
radiation (EBRT) to enhance radiation effect at tumor site or
sometimes it is used as a stand alone treatment in some cancers.
Method of delivery
- Brachytherapy treatment is delivered using a Gamma Med plus X machine
- Applicators or instruments are placed inside the patient’s body and the applicators are connected to the radiation machine.
- Inside the machine, a radioactive source is made to travel through the connecting wires and into the patient’s body where it stays for the desired amount of time in order to achieve the desired dose according to the patient’s need and then retrieved back after treatment is finished.
Types of brachytherapy
01.Intracavitary brachytherapy
- This type of brachytherapy is used in gynaecological cancers like Cervical cancer, vaginal cancers, and endometrial cancers.
- This type of brachytherapy is most commonly used in radiation practice
02 .Interstitial brachytherapy
- This type of brachytherapy is used in treatment of many cancers like Cervical
cancer, vulvar cancer, soft tissue sarcomas, and head and neck cancers. - In this brachytherapy, interstitial needles are placed inside the tumor or nearby the tumor where radiation dose is required.
- It’s a highly specialized technique that makes it possible to treat tumors that are difficult to treat with other forms of radiation
03 .Intraluminal brachytherapy
- This is used to treat Cancer of the esophagus.
- In this treatment, a tube is passed inside the food pipe and brachytherapy is delivered through it.
04 .Surface mould brachytherapy
- In this type of brachytherapy, we prepare a mould specially for each person that has small wires running through it
- This mould is then placed on the patient’s skin or the area where we want to treat and connected to the radiation machine
- This brachytherapy is generally used to treat superficial cancers like skin and vulva
05 .Permanent brachytherapy Implants
- In some cases brachytherapy is also used as permanent implants inside the tumor.
- This is practiced mainly in Cancer of the prostate, wherein radioactive source with low activity are implanted inside the prostate and left in place.
- These implants or seeds remain there till their strength is over and provide continuous radiation therapy.
Advantages of brachytherapy
- Brachytherapy is the most conformal of all types of radiation treatment.
- It can deliver high doses of radiation to the desired area of treatment while having a very sharp dose fall off.
- This property of brachytherapy ensures that unwanted effects of radiation therapy are kept to a minimum as the normal tissue toxicity is very less.
- Radiation dose is delivered in a short duration.
- Preservation of normal anatomy of the body, no disfigurement can be expected
- It has less radiation morbidity
Side effects of brachytherapy
- Brachytherapy is a relatively safe procedure with minimal adverse effects
- Side effects are generally dependent on the part of the body irradiated
- Patients can experience uneasiness during the procedure
- Nausea, vomiting, loose stools and skin changes are present occasionally
Brachytherapy procedure in Gynaecological cancers
- These treatments can be done under short anesthesia or under local anesthesia
- Intracavitary treatments requiring cylinders generally don’t require anesthesia they are done as an OPD procedure.
- Intracavitary treatments that require tandems and ovoids require short anesthesia and 1 day of admission
- They are generally scheduled 1 week after the completion of EBRT and scheduled over 3 weeks, with 1 sitting in each week
- Treatment duration is 10- 20m minutes