High Dose Rate (HDR) brachytherapy is an advanced treatment for of internal radiation that allows physicians to deliver precise radiation treatment to a patient’s cancerous tumors. It is frequently used in the treatment of cervical and uterine cancers, certain lung cancers causing bronchial obstructions and obstructing esophageal cancers. It has also recently shown to be effective for treatment of early stage prostate cancer.
What is HDR brachytherapy?
- High Dose Rate (HDR) brachytherapy is a leading-edge treatment that allows physicians to deliver precise radiation treatment directly to a patient’s cancerous tumors through the use of catheters, thin, flexible needles or applicators inserted into a body cavity or directly into the tissue.
- It is a computer-controlled delivery system that optimizes dose distribution to the target.
- HDR brachytherapy is frequently used in the treatment of cervical and uterine cancers, intraluminal treatment of certain lung cancers causing bronchial obstructions and obstructing esophageal cancers. It has also recently been shown to be effective for treatment of early stage prostate cancer.
Why is it used?
- HDR brachytherapy delivers radiation with extreme precision. Advanced imaging allows catheters to be precisely located so the intended dose can be delivered to a position with 1-millimeter accuracy.
- Unlike low dose rate brachytherapy treatment, HDR brachytherapy can often be delivered on an outpatient basis and no radioactive material is left in the body.
- Treatment times are typically several minutes in duration instead of several days that are required for low dose rate brachytherapy.
- Because radiation is delivered directly to the tumor, a higher dose is used, yet exposure to surrounding healthy tissue is limited. HDR brachytherapy results in less than a two percent chance for permanent damage to any of the adjacent normal tissue.
How is HDR brachytherapy treatment planned and delivered?
- The physician determines whether HDR brachytherapy will be administered through a thin catheter, a flexible needle placed through the skin, or through applicators that are inserted into a body cavity such as the lung or esophagus.
- Patients are treated in the physician’s office, with sedation if needed, or under anesthesia in the hospital operating room.
- When catheters are used, treatment may be delivered intermittently over several days. Depending on the type of cancer for which the patient is being treated, catheters could remain in place during treatment, which may last several minutes to several hours.
- Following a computed tomography (CT) scan of the treatment area, a three-dimensional reconstruction of the target organ/cancer and adjacent tissue is made to confirm placement of the implant device and plan the delivery sequence of the radioactive source for ideal dose distribution.
- The HDR brachytherapy equipment is programmed with the patient’s specific treatment and connected to the implant device with transfer tubes.
- Each treatment will last between 10-15 minutes, and during the treatment, the physician and clinical staff continually monitor and communicate with the patient from a room directly outside the treatment room.
- When treatment is complete, the radioactive source retracts back into the HDR brachytherapy machine, and the transfer tubes are disconnected. For weekly implants or if doses will be delivered weekly, delivery devices are removed and the patient returns home after the procedure. For an implant series extending over several consecutive days, the patient remains in the hospital for comfort and support between treatment deliveries, and delivery devices are removed once the final treatment is complete.