Head and neck brachytherapy An indispensable part of radiation therapy

Why brachytherapy for head and neck?

  • Brachytherapy is an important and successful part of the multidisciplinary treatment of head and neck cancer
  • Can be used as a stand alone treatment or in combination with external beam radiation therapy
  • Valuable also for salvage treatments

G. Kovács et al. GEC-ESTRO ACROP recommendations for head & neck brachytherapy in squamous cell carcinomas: 1st update – Improvement by cross sectional imaging based treatment planning and stepping source technology / Radiotherapy and Oncology 122 (2017) 248–254 [https://www.thegreenjournal.com/article/S0167-8140(16)34346-8/pdf]

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

Head and neck applicators

Our wide array of applicators are available for many applications, the Nasopharyngeal applicator and different sizes of flexible catheters with corresponding buttons can be used for different head and neck body areas.

View applicator guide

Nasopharyngeal applicator
Nasopharyngeal applicator

Applicator insertion

Rotterdam Nasopharyngeal Mold Applicator Optimal dose shaping in nasopharyngeal cavities The Rotterdam nasopharyngeal mold is manufactured from a flexible silicone material to easily shape the radiation dose in the nasopharyngeal cavity. It consists of two channels on the upper surface to optimize the dose distribution and reduce the surface dose. The mold can remain in place for a series of treatment fractions, while the treatment catheters will be replaced per fraction. This way, patient discomfort between fractions is minimized. Why the Rotterdam nasopharyngeal mold applicator?

  • Easily conforms to a range of nasopharyngeal cavity sizes
  • Dual-channel design for optimized dose distribution
  • Quick catheter reinsertion for follow-up fractions
OIS connectivity
Nasopharyngeal applicator

Why the Rotterdam nasopharyngeal mold applicator?

  • Easily conforms to a range of nasopharyngeal cavity sizes
  • Dual-channel design for optimized dose distribution
  • Quick catheter reinsertion for follow-up fractions

Imaging

Determine applicator position relative to tumor and OaR


Image data set for treatment planning is obtained through X-ray, CT or MR imaging. The image quality determines the applictor visibility for correct recontruction It also give the anatomy landscap which shows the tumor and the OaR

OIS connectivity
X-ray image of flexible catheters with X-ray markers
"I wanted an applicator that was easy to use, did not require a general anesthetic and that would closely conform to the mucosa of the nasopharynx. I found it in the Rotterdam nasopharyngeal applicator."
Prof. Dr. P. Levendag (1949-2018)
Daniel den Hoed Clinic Rotterdam,
The Netherlands

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.

View brochure




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
  • Accuracy similar to Monte Carlo and faster calculation times
  • 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

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.



Learn more

 

About Brachytherapy

Screenshot About Brachytherapy

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

Learn more

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.

Learn more

Elekta Care circle

Contact us