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Emerging and Re-Emerging Brachytherapy Treatments

A Damato1*, S Abbasinejad Enger2*, K Roberts3*, J Prisciandaro4*, D Han5*, D Aramburu Nunez6*, (1) Memorial Sloan Kettering Cancer Center, New York, NY, (2) McGill University, Montreal, QC, CA, (3) Yale University, New Haven, CT, (4) University of Michigan, Ann Arbor, MI, (5) Yale University, Woodbridge, CT, (6) New York, NY

Presentations

TU-AB-BRA-0 (Tuesday, 7/12/2022) 7:30 AM - 9:30 AM [Eastern Time (GMT-4)]

Ballroom A

During the past century, physicists have investigated and developed advanced methods to maximize patient treatment outcomes with reduced side effects. These efforts led to the next generation of brachytherapy technology. With high dose gradients, brachytherapy can allow for the treatment of highly complex anatomic lesions. In this session, we will introduce emerging and re-emerging brachytherapy technologies: (1) diffusing alpha emitter (Ra-224) radiation therapy, (2) intravascular brachytherapy using beta emitting radiation source (Y-90/Sr-90), and (3) devices using Cs-131 embedded in novel polymers.
The first talk will introduce diffusing alpha emitter radiation therapy (DaRT), which is a novel brachytherapy treatment option for treatment of solid tumors through alpha emitters released from Ra-224 loaded brachytherapy seeds. DaRT has generated significant interest in North America and around the world with multiple institutions showing interest in participating in clinical trials. Due to the novel nature of this technology, there is a considerable uncertainty among practitioners on how to translate common brachytherapy QA and treatment planning practices to these devices. This session will introduce the DaRT, its promises, and its challenges.
The second talk will present intravascular brachytherapy (IVBT). Until introduction and early results of drug eluting stent (DES) trials, coronary artery brachytherapy played major role in reducing the risk of in-stent-restenosis (ISR). However, longer follow-up of patients treated with DES versus IVBT, as well as the continued presentation of ISR, has prompted a comeback of coronary artery brachytherapy. This session will provide an overview of coronary artery disease, treatment options, the upgraded IVBT device, and share clinic procedures with physicists who are interested and/or tasked with (re)introducing IVBT to their institutions.
The third talk will focus on devices using Cs-131 embedded in polymers. Brachytherapy has been used to treat brain tumors since at least 1914 using a variety of isotopes and techniques. Recently, a technique using Cs-131 seeds pre-embedded in polymers has emerged and gained popularity. This session aims to give a background of the different isotopes used for brain malignancies and their formulations, understating their advantages, disadvantages, and challenges for implementing them in the clinic.

Learning Objectives:
1. Familiarize with the physics of Recoil Short-lived Alpha Emitting Devices and clinical implementation.
2. Understanding coronary artery disease and intravascular brachytherapy
3. Understanding device using Cs-131 embedded in polymers for brain brachytherapy

Handouts

Keywords

Brachytherapy, Alpha-particles, Intravascular Brachytherapy

Taxonomy

TH- Brachytherapy: Development (new technology and techniques)

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