Interstitial Brachytherapy Unit
About
Our comprehensive and technologically advanced Clinic for interventional radiotherapy-brachytherapy enjoys worldwide recognition. Brachytherapy is an internal radiation treatment, using radioactive sources. This is the main factor that makes it differ from external radiotherapy, where rays are administered to the patient from outside the body.
In High Dose Rate (HDR) Brachytherapy, small needles (catheters) are placed directly into or next to the tumor, under the image guidance of CT Scan, MRI, Ultrasound, and/or a combination of them. Tubes/cables will then be connected to the needles, and will link to a machine which stores the radioactive source (Iridium – 192). The source will then be administered to the patient for a specific time, which is calculated for the so-called “radiotherapy plan” by our Medical Physicists. With this very targeted and precise method, high-dose radiation is delivered right into the tumor, and at the same time the surrounding healthy tissues are well protected by it.
Brachytherapy can be applied, either independently or in combination with external radiotherapy, as a highly effective treatment for many types of cancer, especially prostate, cervical and breast cancer, soft tissue sarcomas, and also in liver and lung metastases.
Brachytherapy, in the way that it has been developed by Professor Zamboglou and his multi-thematic team of scientists in Germany for a period of almost 25 years, can target the tumor with great precision and blast it with much higher doses of radiation that external radiotherapy can use. These high doses are necessary in order to achieve local control of the cancer. In specific case, this method may be used either independently, or in combination with external radiotherapy.
Over the years, this method, as it is practiced now at the German Oncology Center, has yielded remarkable results in treating prostate, cervical and breast cancers. Results, which have been published in recognized and respected medical journals worldwide.
In high-dose rate brachytherapy offered at the GOC, guided catheters are precisely placed inside or near the tumor based on pre-determined locations. This is done under the guidance of imaging techniques such as ultrasound or CT scans. Once the dosimetric plan is conducted, detailing the exact placement and duration the catheter needles should remain inside the patient, these catheters are connected with tubes to a computer-controlled machine known as an afterloader.
The afterloader accurately directs a small radioactive source (Iridium) through the tubes and catheters to deliver targeted radiation doses with sharp gradients to the tumor. The duration and location of the radiation are meticulously controlled by the computer to ensure precise dosage delivery to the tumor.
This procedure is conducted in specially designed, radiation-shielded rooms. Although the patients are alone during the treatment, they are continuously monitored by a doctor and a medical physicist through a camera.
After the radiation delivery, the catheters are either removed, if it is a single session treatment, or left implanted for future sessions if additional treatments are scheduled in the following days.
• Prostate Cancer
Interstitial brachytherapy is a scientifically validated alternative to prostate tumor removal surgery or multiple radiotherapy sessions. According to a report cited in international journals, a comprehensive meta-analysis involving data from 52,000 patients demonstrates that interstitial brachytherapy achieves success rates comparable to those of the other two methods. Additionally, interstitial brachytherapy offers significant advantages in terms of side effects, with less than 1% of patients experiencing urinary incontinence and fewer than 5% encountering serious (Grade 3-4) gastrointestinal or urinary system side effects. Moreover, over 75% of patients maintain erectile function. This treatment can be completed in just one or two sessions, with each session typically followed by a brief monitoring period in the hospital ward.
• Breast Cancer
For patients with breast cancer, radiotherapy following surgical tumor removal significantly enhances survival rates and is a crucial component of treatment at every stage of the disease. For those with low-risk cancer, partial breast radiation treatment using interstitial brachytherapy presents a highly effective alternative, consistently yielding promising outcomes. Compared to external radiotherapy, interstitial brachytherapy is administered twice daily over a period of 5 to 7 days. This technique focuses radiation directly at the tumor bed, markedly reducing radiation exposure to the skin, heart, and lungs.
• Cervical Cancer
Brachytherapy plays a critical role in the treatment of cervical cancer. Research indicates that integrating brachytherapy into the treatment regimen can enhance survival rates by 20-40%. The treatment is especially beneficial for tumors that are large, irregularly shaped, or extend beyond the cervix, areas which traditional intravaginal brachytherapy might not adequately reach. Magnetic Resonance Imaging (MRI) is employed to meticulously craft the brachytherapy plan, allowing for precise tumor delineation and assessment of the tumor’s response to previous radiotherapy sessions. Advanced image-guided brachytherapy achieves local control rates of 80-100%, depending on the cancer stage, with serious gastrointestinal side effects occurring in less than 5% of cases.
• Palliative Care
Palliative radiotherapy is primarily advised for managing symptoms such as pain, bleeding, ulcers, and shortness of breath in cases of locally advanced cancers and certain metastases. The objective is to enhance the quality of life for patients and to slow disease progression. Brachytherapy is particularly advantageous in palliative care due to its capability to deliver high doses of radiation directly within the tumor, leading to a rapid therapeutic effect and minimal side effects. Brachytherapy can be applied in a single or a few sessions, depending on the disease’s extent, location, and histology. It has been successfully utilized in managing recurrences of brain and head-neck tumors, as well as in treating primary and secondary tumors in the lungs and liver, soft tissue sarcomas, bladder tumors, prostate tumor recurrences, and bone metastases.
