HDR BrachytherapyHDR Brachytherapy

Nicolas G. Zouain, MD

Department of Radiation Oncology

Roger Maris Cancer Center

History19051905

History

1920’s1920’s

Dose Rate

Low dose rate (LDR)0.4 to 2 Gy/hr

Medium dose rate (MDR)2 to 12 Gy/hr

High dose rate (HDR)> 12 Gy/hr but usually in the region of 150 Gy/hr ~ 2.5 Gy/min

Why Brachytherapy

Delivering the high dose of radiation to the tumor

Sparing of the surrounding normal tissues

Delivered in a short period of timeTumor repopulation

Limited to localized tumors

High Dose Inside of the Tumor

100%100%

25%25%

150%150%

HDR Afterloading Machine

Iridium-192Iridium-192

Prostate HDR Brachytherapy

Breast HDR Brachytherapy

Lungs HDR Brachytherapy

Esophagus HDR Brachytherapy

Cervix HDR Brachytherapy

Uterus HDR Brachytherapy

H&N HDR Brachytherapy

H&N HDR Brachytherapy

Rectal Brachytherapy

Rectal Brachytherapy

Rectal Brachytherapy

Templates

Trans Rectal Ultrasound

Ultrasound Stepper

Ultrasound Stepper Stabilizer

TRUS Guided Needles Insertion

MammoSite

MammoSite

Lumpectomy Cavity is Created

Troacar Used to CreatePathway to Cavity

Un-inflated MammoSite is Advanced into the CavityThrough the Troacar Path

MammoSite

MammoSite is Inflated toPosition the Tissue to

Receive Radiation Therapy

Design allows the 192IrSource to be Centrally Positioned within the

Applicator

The 192Ir Source is Delivered Into the MammoSite and

Radiation Therapy is Delivered Per the

Treatment Plan

MammoSite