What is Brachytherapy?

Brachytherapy is a type of radiotherapy where radioactive sources/radiation source is placed next to the tumor. It is being successfully used for the treatment of gynecological cancers (uterine, cervix, vagina), lung cancer, skin cancer. Today, brachytherapy can be applied as 3-dimensional with the use of imaging methods that are based on cross sectional anatomy like computed tomography and magnetic resonance imaging. As 3-dimensional brachytherapy is more frequently used, success rates increase and side effects decrease. Liv Hospital Radiation Oncology Specialist Prof. Dr. Merdan Fayda explained the brachytherapy method.


 

Brachytherapy has three fundamental application methods:

1. Intracavitary brachytherapy: (Inside the cavities) performed by using applicators placed inside the natural cavities of the patient (uterine, cervix, bronchi etc).
2. Interstitial brachytherapy: (Inside the tissue) performed by placing applicators inside the related tissues or by using radioactive sources delivered through a needle, as well as permanent placement of radioactive sources (permanent prostate uLDR brachytherapy).
3. Contact brachytherapy: Radioactive source/radiation source is applied to external tissues such as kin or is applied at the time of removal of other organs during operation like in superficial intraoperative radiotherapy (IORT).

 

3 Dimensional Brachytherapy in Gynecological Tumors

In the treatment of gynecological tumors performed by physicians from different disciplines, brachytherapy has an important function and is applied by bringing radioactive sources near the area to be irradiated.

The most frequent area of use for brachytherapy is gynecological cancers. For uterus cancers (endometrium), cervical cancers and vagina cancers brachytherapy is applied after the operation, and in case of patients not fit for the operation, it is applied as single therapy method along with external irradiation.

Especially in the recent years, brachytherapy applications developed from 2-dimensional methods to 3-dimensional methods. Based on data acquired from computerized tomography and MR devices, 3-dimensional brachytheraphy applications contributes to the successful treatment of gynecological cancers and provides suitable protection for the surrounding tissues (bladder, rectum, sigmoid etc). This allows the treatment to be completed with less side effects.
 

Skin Brachytherapy (with Leipzig applicator)

Brachytheraphy is successfully used for the treatment of early phase of skin squamous and basal cell cancers with a suitable depth and surface. Cosmetic damages arising from operation during the treatment of the tumors especially developing around the face are seen less with brachytherapy. Patients suffering from early stage skin cancer localized on the face may be treated with brachytheraphy if deemed eligible by the plastic surgeon.
 

3-Dimensional Brachytherapy in Lung (bronchi) Cancers

In case of patients for whom external irradiation methods cannot be used in the radiotherapy of lung cancer, brachytheraphy can be performed through tubes to be placed inside the main airways with the assistance of pulmonology team.

In order to bring the radioactive source near the target area of the patient, certain assistant instruments such as applicators may be used. Although these applicators are mostly placed without any pain, sometimes anesthesia may be necessary.