Bronchus and esophagus brachytherapy An indispensible part of radiation therapy

Why brachytherapy for bronchus and esophagus?

  • High, conformal dose
  • Small volume
  • Sparing the normal lung tissue
  • Follows breathing movement
  • Suitable for curative and palliative treatments

Ensuring a smooth clinical workflow

Connectivity to MOSAIQ® OIS

Confidence for you and your patients


  • Contributes to paperless brachytherapy workflow information
  • Automated scheduling and billing process
  • Documented dose and structure sets
  • Automatically exchange treatment plans created with Oncentra Brachy and treatment records generated by the afterloader
  • Perform dose tracking based on the treatment plan and treatment record for the selected and verified patient
  • Provide a more efficient and electronic way to capture information that will be included in the patient’s Continuity of Care Document (CCD), data as required for meaningful use (Stage 1 and beyond)

Applicator selection

Diagnostic imaging guides the applicator choice


Bronchus and Esophagus Applicators

Elekta offers two advanced applicators for lung and other intraluminal brachytherapy applications. The LumenCare® Azure Applicator is specifically designed to improve the delivery of lung cancer brachytherapy treatments, expanding the treatable area.

“The more flexible and kink-resistant material of the LumenCare Azure makes it much easier to reach tumors in the upper lobe, an area where many of the lung tumors tend to occur.”
Janusz Skowronek, PhD, Asst. Prof.
Head of Brachytherapy Department
Greater Poland Cancer Centre
Poznań, Poland

Applicator insertion

Bonvoisin-Gérard Esophageal Applicator Set

Bonvoisin-Gérard Esophageal Applicator Set

The Bonvoisin-Gérard esophageal applicator is designed to assist in the treatment of an endoscopically obstructed esophagus. By using this special dilation applicator with tapered flexible tip, the treatment area can be reached by bouginage. The bougie tube will also assist in centering the treatment catheter internally to minimize the mucosal dose, while ensuring optimal depth dose penetration of the esophageal wall. Radiographic markers on the bougie tube aid in fluoroscopic placement and localization of the applicator.

  • Easy applicator insertion using endoscopy
  • Excellent source centering
  • Radio-opaque applicator marking assists placement and localization
LumenCare® Azure Applicator Set

LumenCare® Azure Applicator Set

The LumenCare Azure applicator set offers clinicians an excellent solution for lung brachytherapy applications. It is specifically designed to improve the delivery of lung cancer brachytherapy treatments, expanding the treatable area.

  • Highly flexible and kink-resistant material to reach challenging tumor locations
  • Smoothness of catheter facilitates fast and simple lung brachytherapy procedures
  • Superior visibility allows for easy insertion into bronchus
Esophageal Applicator Set

Esophageal Applicator Set

The esophageal applicator is designed for direct insertion into the esophagus. The applicator can be positioned orally under fluoroscopy or endoscopic examination. It is provided with an additional outer layer to reduce the dose to the esophageal mucosa and support applicator integrity.

  • Specific outer applicator surface reduces dose to mucosa
  • Easy applicator insertion using fluoroscopy

Imaging

Determine applicator position relative to tumor and OaR


This step is not always done when it comes to bronchus and esophagus, in some cases a CT will be done which will be used for the treatment planning. In case of esophagus this could be a standard plan.

LumenCare® applicator – Image courtesy of the UZL Gasthuisberg, Leuven, Belgium
LumenCare® applicator – Image courtesy of the UZL Gasthuisberg, Leuven, Belgium
CT
CT
 LumenCare® applicator – Image courtesy of the UZL Gasthuisberg, Leuven, Belgium CT
LumenCare® applicator – Image courtesy of the UZL Gasthuisberg, Leuven, Belgium CT
CT
CT

Treatment planning

Homogeneous dose delivery on the target while sparing the OaR


Oncentra Brachy

Comprehensive treatment planning software

Designing the optimal dose distribution can be a time-consuming job. The latest version of Oncentra Brachy offers a series of useful tools that simplify many repetitive tasks, such as contouring and reconstruction. Oncentra Brachy buys you time to focus on what counts: creating the optimal dose distribution.

Oncentra Brachy also helps you optimize treatment plan accuracy, providing easy navigation to any plane that offers the most relevant information per region of interest. Template solutions for repetitive tasks, such as the new Implant Modeling tool and the popular Applicator Modeling feature, help reduce implant reconstruction time. DVH presets and the ROI Catalog Manager can help improve accuracy and reproducibility. Powerful inverse planning optimization automates volume-based planning, making the process fast and efficient.


Reduce implant reconstruction time

  • Instant applicator reconstruction in relation to anatomy
  • Contains the complete geometry of Elekta’s gynecological applicators
  • Includes the measured source paths of ring applicators
  • Accounts for dose attenuation resulting from shielding during planning and shields are fully visible

Dose distribution calculated by ACE

  • Algorithm based on the TG-186 recommendations published by the AAPM workgroup in 2012
  • Algorithm based on the TG-186 recommendations published by the AAPM workgroup in 2012
  • Discriminates between tissue, air and bone
  • Accounts for tissue heterogeneities, lack of backscatter from areas with no tissue, applicator attenuation and shielding

Implant modeling tool

  • Reconstruct multicatheter implants immediately
  • Drag & Drop 3D applicator geometry for accurate and fast reconstruction
  • Extra Coordinate System (ECS) allows quick and easy navigation to the correct plane views

Automatic dose optimization

IPSA

  • Paired with the Dwell Time Deviation Constraint (DTDC)
  • Limits high variation in dwell times

HIPO

  • Improves plan optimization with Dwell Time Gradient Restriction (DTGR)
  • Control high and low peaks in dwell times
  • Focus optimization where it is needed with needle locking

Treatment delivery

Safe, simple, intuitive brachytherapy workflow


Five simple features are the basis for the Flexitron way of working, introducing a new standard in treatment delivery

  • Standardized transfer lengths, less prone to human errors during reconstruction as there is only one indexer length.
  • Reference zero at entrance of applicator, no need to measure the distal tip.
  • Metric dwell position numbering, 1 mm step size in a treatment window of 400 mm.
  • Forward stepping results in a reproducible source positioning within 0,5mm accuracy
  • Intuitive user interface, smooth navigation saves time.

Why Flexitron?

  • Simple quality assurance
  • 40-channel option for large implants
  • Connected to major oncology systems such as MOSAIQ®
  • Safe investment with future upgrade potential
  • Available in either Iridium-192 or Cobalt-60*

* Not available in all countries.

Patient out

Find out about brachytherapy for other body regions


 
human-body-figure H e a d a n d n e c k B r e a s t Gyn e c ol o g y B r on c h u s a n d e sop h a g u s S k i n B l add e r P r o s t a t e R e c t u m

What our customers say

Clatterbridge Cancer Centre, United Kingdom

Clatterbridge Cancer Centre, United Kingdom

 

BrachyAcademy

Empowering through education


Peer-to-peer education platform for brachytherapy professionals

The BrachyAcademy comprises a complete peer-to-peer medical education library and includes programs such as clinical workshops and training visits to leading hospitals worldwide.

 

About Brachytherapy

Elekta also offers the only online brachytherapy portal for patients including awareness materials:

Elekta Care™



Elekta Care supports you from startup through your product's lifecycle with comprehensive options from education, training and upgrades to solutions allowing you the highest uptime and improved operational efficiency.

Contact us