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2017 ; 9
(4
): 148-154
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New era of electronic brachytherapy
#MMPMID28529679
Ramachandran P
World J Radiol
2017[Apr]; 9
(4
): 148-154
PMID28529679
show ga
Traditional brachytherapy refers to the placement of radioactive sources on or
inside the cancer tissues. Based on the type of sources, brachytherapy can be
classified as radionuclide and electronic brachytherapy. Electronic brachytherapy
uses miniaturized X-ray sources instead of radionuclides to deliver high doses of
radiation. The advantages of electronic brachytherapy include low dose to organs
at risk, reduced dose to treating staff, no leakage radiation in off state, less
shielding, and no radioactive waste. Most of these systems operate between 50 and
100 kVp and are widely used in the treatment of skin cancer. Intrabeam, Xoft and
Papillon systems are also used in the treatment of intra-operative radiotherapy
to breast in addition to other treatment sites. The rapid fall-off in the dose
due to its low energy is a highly desirable property in brachytherapy and results
in a reduced dose to the surrounding normal tissues compared to the Ir-192
source. The Xoft Axxent brachytherapy system uses a 2.25 mm miniaturized X-ray
tube and the source almost mimics the high dose rate Ir-192 source in terms of
dose rate and it is the only electronic brachytherapy system specifically used in
the treatment of cervical cancers. One of the limiting factors that impede the
use of electronic brachytherapy for interstitial application is the source
dimension. However, it is highly anticipated that the design of miniaturized
X-ray tube closer to the dimension of an Ir-192 wire is not too far away, and the
new era of electronic brachytherapy has just begun.
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