Asim Farooki

DOS 525 Brachytherapy

April 2014

Brachytherapy Surface Applications

Brachytherapy is a type of radiation therapy that is delivered from an internal
source instead of an external beam. This is done by directly placing radioactive materials
into or as close as possible to the cancer. This type of radiation is beneficial because it
travels a very short distance in the body and thus helps by sparing as many healthy cells
as possible and most importantly with this mode of therapy, a high radiation dose is
delivered locally to the tumor with rapid dose falloff in the surrounding normal tissue.
1

Brachytherapy can be administered using several different techniques, which
include interstitial, intracavitary, intraluminary, and surface treatment brachytherapy.
2

Surface application brachytherapy is very beneficial in treating certain cancer cases, such
as retinoblastoma because it increases the chances for eye preservation.
2
Initially cobalt-
60 was used in brachytherapy for the treatment of retinoblastoma, however now it has
been replaced with Iodine 125 and the salvage plaque therapy method has shown to be an
optimal treatment choice in the overall eye preservation.
2

Tumors between 6 and 18 mm in height are considered suitable for the procedure
and a margin of 1-2 mm around the tumor is indicated.
3
The prescribed treatment is a
dose rate between 0.4 and 0.8 Gy/h delivered with a total dose to the tumor apect of 30-
45 Gy over 2-5 day period.
3
Patients are treated in a supine position using a custom
Aquapast mask with cutouts around the eyes to immobilize the face.
125
I is embedded in a
methylmethacylate eye prosthesis, which is placed on the cornea during brachytherapy.


Figure 1: Retinoblastoma



Figure 2: A A Surgical insertion of the brachytherapy iodine-125 plaque.
B: The gold plaque and silicone radioactive seed carrier.


Figure 3: (a) Circular COMS plaque seen above along with the corresponding
circular siliastic carrier below which is loaded with the I-125 seeds.
(b) Siliastic carrier fitted in the COMS plaque with the seeds on inside surface



References:
1. Khan F. The Physics of Radiation Therapy. 4
th
ed. Baltimore, MD: Lippincott
Williams & Wilkins; 2010.
2. Devlin P. Brachytherapy Applications and Techniques. Philadelphia, PA:
Lippincott Williams & Wilkins; 2007.
3. Singh A. Ophthalmic radiation therapy : techniques and applications. Basel:
Karger; 2013.

Image References:
Figure 1: Singh A. Ophthalmic radiation therapy : techniques and applications.
Figure 2: http://www.elsevierimages.com/image/27680.htm
Figure 3:
http://www.ijo.in/viewimage.asp?img=IndianJOphthalmol_2012_60_4_289_98708_f2.jp
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