Brachytherapy Source, Non-stranded, High Dose Rate Iridium-192, Per Source (C1717)

Name of the Procedure:

• Common Name: High Dose Rate (HDR) Brachytherapy
• Medical Term: Brachytherapy Source, Non-stranded, High Dose Rate Iridium-192

Summary

High Dose Rate Brachytherapy is a form of internal radiation therapy where a small, highly radioactive Iridium-192 source is placed close to or within the tumor. This procedure allows for a high dose of radiation to be delivered directly to the cancerous cells with minimal impact on surrounding healthy tissues.

Purpose

HDR Brachytherapy is used to treat various cancers, including prostate, cervical, breast, and skin cancers. It aims to shrink or eliminate tumors while sparing healthy tissue and organs. By targeting the tumor directly, it allows for more effective treatment with fewer side effects compared to traditional external beam radiation therapy.

Indications

• Tumors located in the prostate, cervix, breast, skin, or other internal organs
• Patients who have localized cancer where high precision is required
• Cases where external radiation therapy alone has not been sufficient

Preparation

• Fasting may be required if anesthesia is used
• Adjustments to medications, particularly blood thinners
• Pre-procedure imaging tests (e.g., MRI, CT scans) for accurate placement of the radiation source
• Informed consent and a discussion about the procedure

Procedure Description

1. Imaging and Planning: Initial imaging such as CT or MRI scans to map out the tumor location and surrounding tissues.
2. Applicator Placement: A specialized applicator is placed in or near the tumor site. This might involve inserting catheters or tubes depending on the tumor location.
3. Radiation Delivery: The high dose rate Iridium-192 source is then temporarily introduced through the applicator, delivering radiation directly to the tumor.
4. Monitoring: Real-time imaging and computers ensure precise positioning and control of radiation dose.
5. Source Removal: After the prescribed dose is delivered, the Iridium-192 source is withdrawn, and the applicator is removed.

• Tools and Equipment: Applicators, catheters, Iridium-192 source, imaging devices (CT, MRI)
• Anesthesia or Sedation: Local or general anesthesia depending on tumor location and patient comfort

Duration

The actual radiation treatment often takes only a few minutes per session, but the entire procedure, including preparation and setup, can take several hours.

Setting

Typically performed in a hospital or an outpatient clinic equipped with specialized radiation therapy facilities.

Personnel

• Radiation oncologist
• Medical physicist
• Radiologist
• Specialized nurses
• Anesthesiologist (if needed)

Risks and Complications

• Common: localized skin irritation, temporary increase in urinary or rectal symptoms
• Rare: infection, bleeding, localized tissue damage, unintended exposure to surrounding healthy tissues

Benefits

• Delivers a high dose of radiation directly to the tumor with precision
• Minimally invasive compared to surgical options
• Typically fewer side effects than external beam radiation
• Shortened overall treatment time

Recovery

• Post-procedure monitoring for a short period
• Mild discomfort or side effects manageable with medications
• Normal activities can often be resumed within a few days
• Follow-up appointments for evaluation and additional treatments if necessary

Alternatives

• External Beam Radiation Therapy (EBRT): longer treatment duration and potential for more side effects
• Surgery: more invasive with longer recovery time
• Chemotherapy: systemic treatment, which may have more widespread side effects
• Combination Therapy: using EBRT and chemotherapy together

Patient Experience

• During the procedure: minimal discomfort, similar to a lengthy imaging session; sedation or anesthesia makes the procedure more comfortable
• After the procedure: some minor pain or irritation, manageable with medications; quick return to normal activities with a focus on post-care instructions

By understanding the procedure and what to expect, patients can approach HDR Brachytherapy with confidence, knowing it is an effective and targeted option for cancer treatment.