[Pulsed-dose rate brachytherapy in cervical cancers: why, how?]

Area of Science:

• Oncology
• Radiation Therapy
• Medical Physics

Background:

• The production of 192 iridium wires, a cornerstone of low dose rate brachytherapy, is ceasing.
• This cessation mandates a transition to alternative brachytherapy techniques.

Purpose of the Study:

• To discuss the implications of discontinuing 192 iridium wire production for brachytherapy.
• To highlight the necessity and benefits of adopting pulsed-dose rate (PDR) or high-dose rate (HDR) brachytherapy, particularly for gynecological cancers.
• To emphasize the role of projector sources in enabling 3D brachytherapy for cervical cancer.

Main Methods:

• Review of current brachytherapy practices and technological advancements.
• Analysis of the transition from low dose rate (LDR) to pulsed-dose rate (PDR) and high-dose rate (HDR) brachytherapy.
• Discussion of the technical requirements for 3D brachytherapy, including projector sources.

Main Results:

• The end of 192 iridium wire production makes LDR brachytherapy obsolete.
• Pulsed-dose rate brachytherapy is a viable and scientifically supported alternative for gynecological cancers.
• 3D brachytherapy, enabled by projector sources, is becoming the standard for cervical cancer treatment.

Conclusions:

• Clinics must transition to PDR or HDR brachytherapy to maintain advanced cancer treatment capabilities.
• Adoption of new technologies requires investment in equipment, training, and organizational adjustments to ensure treatment quality.
• The shift facilitates the implementation of 3D brachytherapy, improving treatment precision for cervical cancers.