Remote afterloading high dose rate radionuclide interstitial or intracavitary brachytherapy, includes basic dosimetry, when performed; over 12 channels
CPT4 code
Name of the Procedure:
Remote Afterloading High Dose Rate (HDR) Radionuclide Interstitial or Intracavitary Brachytherapy, Includes Basic Dosimetry, When Performed; Over 12 Channels.
Summary
Remote afterloading HDR brachytherapy is a cancer treatment that places a radioactive source inside or close to the tumor temporarily. Using advanced technology, the procedure delivers a high dose of radiation precisely to the cancerous area through over 12 channels while minimizing exposure to surrounding healthy tissues.
Purpose
This procedure aims to treat certain types of cancers effectively by delivering a high dose of radiation directly to the tumor. The goals are to shrink or destroy the tumor while reducing side effects and preserving healthy tissue.
Indications
- Cervical cancer
- Prostate cancer
- Breast cancer
- Head and neck cancers
- Gynecological cancers
- Other localized tumors
Patients who require targeted radiation therapy with minimal exposure to surrounding tissues may be good candidates for this procedure.
Preparation
- Patients may need to fast for a few hours before the procedure.
- Medications may need adjustment as directed by the healthcare provider.
- Imaging tests such as CT, MRI, or ultrasound may be required to plan the treatment accurately.
Procedure Description
- The patient is positioned comfortably, and an applicator is placed in the tumor area, either interstitially or intracavitary.
- Remote afterloading equipment is connected to the applicator.
- A computer-controlled system delivers the radioactive source to the tumor through pre-planned channels.
- The basic dosimetry calculates the needed radiation dose.
- After the prescribed dose is delivered, the radioactive source automatically retracts, and the applicator is removed.
Tools and Technology:
- Applicator (e.g., catheters or specialized probes)
- Remote afterloading machine
- Radiation planning software
- Imaging equipment
Anesthesia:
Local or general anesthesia, depending on the tumor location and patient comfort.
Duration
The procedure typically takes 1 to 2 hours, including preparation time.
Setting
The procedure is generally performed in a hospital or specialized outpatient clinic equipped with radiation therapy facilities.
Personnel
- Radiation oncologist
- Medical physicist
- Dosimetrist
- Radiologic technologist
- Nursing staff
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
- Common risks: discomfort at the application site, minor bleeding, or infection.
- Rare risks: damage to nearby organs, radiation burns, or adverse reactions to anesthesia.
Benefits
- Targeted high-dose radiation potentially offers better control over the tumor.
- Minimizes radiation exposure to healthy tissues.
- Shorter treatment times compared to traditional radiation therapy.
Recovery
- Most patients can go home the same day.
- Mild discomfort or localized pain may be managed with pain relief medications.
- Follow-up appointments are necessary to monitor the treatment's effectiveness.
Alternatives
Other treatment options include:
- External beam radiation therapy
- Surgery
- Chemotherapy
Each alternative has its pros and cons, including different side effects, treatment durations, and effectiveness depending on the cancer type.
Patient Experience
During the procedure, patients may feel slight discomfort from the applicator placement. Post-procedure, mild soreness or fatigue is common but usually resolves quickly. Pain management strategies and a supportive care team work together to ensure patient comfort and a positive treatment experience.