The P&CP clinical staff has significant experience in the commissioning and development of HDR programs, including the treatment of early stage breast cancer (MammoSite) and the treatment of prostate cancer.


High Dose Rate (HDR) brachytherapy is touted by its proponents as the only true "conformal" radiotherapy. HDR has the advantages of an implant - high dose within the target area and minimal dose to the surrounding tissue. The added benefits are decreased exposure to the staff (treatments are performed remotely in a shielded room) and the patient is not radioactive after treatment.


One exciting application of HDR brachytherapy is in the area called Partial Breast Irradiation (PBI). Of the three techniques currently under a Phase III trial, two involve the use of HDR. One of these, the MammoSite balloon catheter by Cytic, is becoming an increasingly popular option for early stage breast cancers. Given limited clinical use approval after only a Phase II trial, over 18,000 women have been treated worldwide utilizing this technology. The other technique utilizing HDR is a multi-catheter interstitial technique, pioneered by Dr. Robert Kuske in the early 1990's. This technique is more invasive, requiring a higher skill set for the Radiation Oncology team. But, it does add eligibility to a subset of patients who do not meet some of the geometric criteria for MammoSite (as examples, small breast size, lumpectomy cavity proximity to skin, and cavity of irregular shape).


Another application gaining popularity is in the treatment of prostate cancer. HDR is currently being utilized for a patient population that is eligible for External Beam Radiation Therapy (EBRT) or a combination of EBRT plus permanent seed implant for the boost.

Some of the advantages of HDR versus permanent implants are:

     

  • patient not radioactive after implant

  • no seed migration after implant

  • better sparing of critical structure such as urethra

  • significantly smaller volume of prostate greater than prescribed dose

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The application of HDR for monotherapy of prostate cancer is in its infancy. An article from the Journal of Radiotherapy Practice entitled "A critical evaluation of the clinical value of high-dose rate brachytherapy in the treatment of prostate cancer" is of interest. A quote from the abstract states, "The HDR delivery and large fraction sizes may be advantageous in tumors sensitive to radiation fraction size, making HDR brachytherapy the treatment of choice over LDR brachytherapy and EBRT".

P&CP can provide services relating to HDR, from complete development of a new program (shielding design, procedure development, etc.), to the introduction of new techniques as described above.

  

Visit us at Booth #1426
ASTRO 2010
San Diego CA
 
 
 
An independent, confidential radiation therapy physics auditing program
 Why should your clinic have an independent medical physics audit?
  • Recently published findings of radiation treatment errors reveal that an audit of your QA program by an outside independent medical physics group can ensure patient safety.
P&CP offers you a safe and efficient auditing system to ensure a sustainable safeguard of your QA program.
  • Our specialists establish a custom program to close the gap between complex new technology and the time and experience of your staff
  • In light of recent concerns over radiation treatment errors, P&CP has become the auditor of choice in centers across the country. This was based on our decade long experience in program start-up, development and implementation of new technology.
     
 
“P&CP has performed exceptionally well in commissioning our new equipment and technology efficiently through experienced physicists with varied backgrounds and resources.”
Karen Johnson
Radiation Oncology Manager
Presbyterian Cancer Services/Charlotte, NC
Email us at: info@pandcp.com  or call us at: 704.897.1228