Why brachytherapy for GYN?
ESMO and ABS recommend the use of brachytherapy as an essential component of the definitive treatment of locally advanced cervical cancer (LACC) – <sup>1, 2</sup>
1. C Marth et al. Cervical cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up Annals of Oncology 28 (Supplement 4): iv72–iv83, 2017.
2. AN Viswanathan et al. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: high-dose-rate brachytherapy. Brachytherapy. 2012 Jan-Feb;11(1):47-52
3. C Haie-Meder et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group* (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol. 2005 Mar;74(3):235-45.
4. R Poetter at al. Recommendations from gynaecological (GYN) GEC ESTRO working group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol. 2006 Jan;78(1):67-77.
5. TP Hellebust et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group: considerations and pitfalls in commissioning and applicator reconstruction in 3D image-based treatment planning of cervix cancer brachytherapy. Radiother Oncol. 2010 Aug;96(2):153-60.
6. JC Dimopoulos et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiother Oncol. 2012 Apr;103(1):113-22.
7. R Poetter et al. The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies. Clin Transl Radiat Oncol. 2018 Jan 11;9:48-60.
8. C Charra-Brunaud et al. Impact of 3D image-based PDR brachytherapy on outcome of patients treated for cervix carcinoma in France: results of the French STIC prospective study. Radiother Oncol. 2012 Jun;103(3):305-13.
9. L Fokdal et al. Image guided adaptive brachytherapy with combined intracavitary and interstitial technique improves the therapeutic ratio in locally advanced cervical cancer: Analysis from the retroEMBRACE study. Radiother Oncol. 2016 Sep;120(3):434-440.
Our wide array of applicators for gynecological brachytherapy are available for many applications, ranging from intracavitary to interstitial use and designed to deliver increasingly more precise doses in gynecologic brachytherapy.
“With Venezia, I expect to treat advanced cervical cancer patients with more ease. Venezia will allow me to reach tumors extended to the parametrium because I can position needles at multiple angles, in the vagina and through the perineum.”
Elekta's new Advanced Gynecological Applicator, Venezia, is a new applicator system that will enable clinicians to easily reach the cervix, parametrium and vaginal extensions in stage IIIA and IIIB tumors. This area has been difficult to reach with current brachytherapy techniques. Venezia enables physicians to treat advanced cervical disease with interstitial brachytherapy in a pre-defined and reproducible way, ensuring optimal dose distribution for the majority of patients. Because of the one-click system Venezia is easy to insert and assemble, eliminating the need for screws or tools.
The combination of Flexitron® treatment delivery and Oncentra Brachy® treatment planning with Venezia provides a truly integrated brachytherapy solution.
“The best case scenario is where you have the availability of ultrasound so that you can actually control the depth of the needles in real time as you’re placing them.”
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
Dose distribution calculated by ACE
Implant modeling tool
Automatic dose optimization
* Not available in all countries.
Spencer Thompson, MD at University of Oklahoma, on Gynecological Brachytherapy
Sabhakar Mutyala, MD at University of Arizona, on Gynecological Brachytherapy
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.