Name of the Procedure:

Remote Afterloading High Dose Rate Radionuclide Skin Surface Brachytherapy (HDR Brachytherapy)

Summary

High Dose Rate (HDR) Brachytherapy is a type of radiation therapy where a radioactive source is temporarily placed close to the skin lesion. This procedure is specifically designed for treating small skin lesions, up to 2.0 cm in diameter, using one channel.

Purpose

HDR Brachytherapy is primarily used to treat small skin cancers and other localized skin conditions. The goal is to deliver a high dose of radiation directly to the lesion to destroy cancerous cells while minimizing exposure to surrounding healthy tissue.

Indications

• Small skin cancers (e.g., basal cell carcinoma, squamous cell carcinoma) up to 2.0 cm in diameter.
• Patients who may not be suitable candidates for surgery.
• Lesions located in cosmetically sensitive areas, like the face, where minimal scarring is important.

Preparation

• Patients may be asked to fast a few hours before the procedure.
• Medication adjustments may be required.
• Pre-procedure imaging studies, like CT or MRI scans, might be necessary to plan the treatment.

Procedure Description

1. Positioning and Setup: The patient is positioned comfortably, and the lesion area is cleaned and prepped.
2. Placement: A catheter or applicator is placed on or into the lesion site.
3. Remote Afterloading: The radioactive source is remotely guided into the catheter or applicator.
4. Radiation Delivery: The source emits high-dose radiation directly to the lesion for a specified time.

5. Removal: The radioactive source is retracted, and the applicator is removed.

   No anesthesia or sedation is usually required as the procedure is quick and minimally invasive.

Duration

The procedure typically takes about 15-30 minutes.

Setting

HDR Brachytherapy is usually performed in a hospital's radiation therapy department or an outpatient clinic specializing in radiation treatments.

Personnel

• Radiation Oncologist
• Radiation Therapy Technologist
• Medical Physicist

Risks and Complications

• Skin irritation or mild burns at the treatment site.
• Temporary redness and swelling.
• Rarely, more severe skin reactions or ulcerations.
• Minimal risk of radiation exposure to surrounding tissue.

Benefits

• Targeted therapy minimizes damage to healthy skin.
• Outpatient procedure with minimal downtime.
• Precisely controlled high doses lead to effective treatment of small lesions.
• Little to no scarring compared to surgical options.

Recovery

• Mild skin reactions should ease within a few weeks.
• Regular follow-up appointments are necessary to monitor healing and effectiveness.
• Patients can usually return to normal activities immediately but should protect the treated area from sun exposure.

Alternatives

• Surgical excision: More invasive, might result in scarring.
• External beam radiation: Longer treatment duration.
• Topical treatments: May be less effective for deeper lesions.
• Cryotherapy: Not as precise for small, cosmetically sensitive areas.

Patient Experience

• During the procedure: Some patients may feel mild discomfort but no significant pain.
• After the procedure: Possible mild redness and swelling, treated with simple topical care.
• Pain management: Usually not required beyond over-the-counter pain relievers.

By understanding the procedure and following your healthcare provider's instructions, you can help ensure the best possible outcome from HDR Brachytherapy.