Intraoperative and percutaneous iridium-192 high-dose-rate brachytherapy for previously irradiated lesions of the spine Journal Article
| Authors: | Folkert, M. R.; Bilsky, M. H.; Cohen, G. N.; Zaider, M.; Lis, E.; Krol, G.; Laufer, I.; Yamada, Y. |
| Article Title: | Intraoperative and percutaneous iridium-192 high-dose-rate brachytherapy for previously irradiated lesions of the spine |
| Abstract: | Purpose: Advances in stereotactic radiosurgery have improved local control of spine metastases, but local failure is still a problem and repeat irradiation is limited by normal tissue tolerance. A novel high-dose-rate (HDR) brachytherapy technique has been developed to treat these previously irradiated lesions. Methods and Materials: Five patients with progressive disease at previously irradiated sites in the spine who were not amenable to further external beam radiation were treated. Catheters were placed intraoperatively in 2 patients and percutaneously implanted in 3 patients with image-guided techniques. Conformal plans were generated to deliver dose to target tissues and spare critical structures. Patients received single-fraction treatment using HDR iridium-192 brachytherapy. Results: Median dose was 14 Gy (range, 12-18 Gy) with a median gross total volume D90 of 75% (range, 31-94%); spinal cord/cauda equina dose constraints were met. At a median followup of 9 months, no local progression of disease has been observed. Four patients had reduction in pain 1-4 weeks after treatment. No brachytherapy-related complications have been observed. Conclusions: Intraoperative and percutaneous iridium-192 HDR spine brachytherapy techniques were not associated with complications or acute toxicity. There has been no local progression at treated sites, and most patients experienced reduction in cancer-related pain. © 2013 American Brachytherapy Society. |
| Keywords: | adult; clinical article; aged; cancer growth; treatment planning; radiation dose; nuclear magnetic resonance imaging; follow up; computer assisted tomography; cancer pain; radiation dose fractionation; spinal cord; spine; brachytherapy; stereotactic radiosurgery; external beam radiotherapy; metastases; computer assisted radiotherapy; analgesia; iridium 192; spine metastasis; fluoroscopy; catheter; recurrent; reirradiation; cauda equina; image guided radiotherapy; high-dose-rate |
| Journal Title: | Brachytherapy |
| Volume: | 12 |
| Issue: | 5 |
| ISSN: | 1538-4721 |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2013-09-01 |
| Start Page: | 449 |
| End Page: | 456 |
| Language: | English |
| DOI: | 10.1016/j.brachy.2013.01.162 |
| PROVIDER: | scopus |
| PUBMED: | 23462536 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 October 2013" - "CODEN: BRACC" - "Source: Scopus" |
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