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[Brachytherapy in choroid tumors]

G B Pizzi1, C Marchetti, M Zemella

  • 1Divisione di Radioterapia Oncologica, Ospedale Umberto I Mestre, Venezia.

La Radiologia Medica
|December 1, 1994
PubMed
Summary

This study presents a custom brachytherapy technique using 192Iridium wires for choroidal tumors. The afterloading method ensures staff safety and delivers a favorable dose distribution for effective treatment.

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Area of Science:

  • Ophthalmology
  • Radiation Oncology
  • Medical Physics

Background:

  • Brachytherapy is an established treatment for choroidal tumors but lacks widespread adoption due to complexity and skill requirements.
  • Current methods often utilize 60Cobalt, 106Rutenium, or 125Iodine seeds, each with specific dose distribution characteristics.
  • 192Iridium wire brachytherapy on custom plaques is a less common but viable alternative.

Purpose of the Study:

  • To describe and evaluate a custom brachytherapy technique using 192Iridium wires for treating choroidal tumors.
  • To highlight the advantages of this afterloading technique in terms of customization, accessibility, staff protection, and dose ratio.

Main Methods:

  • Developed a custom applicator using a quick-drying paste and plastic tubes for housing 192Iridium wires, sized to the affected eye.

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  • Surgical placement of the applicator at the tumor site, followed by afterloading of 192Iridium sources.
  • Utilized preliminary dosimetric measurements to guide the placement of iridium wires within the tubes.
  • Main Results:

    • Successfully treated 4 retinoblastomas and 2 choroidal melanomas using this technique.
    • 192Iridium (320 keV) offers deeper dose penetration compared to 125Iodine (30 keV) and a more favorable surface dose than 106Rutenium (beta emitter).
    • Compared to 60Cobalt (1250 keV), 192Iridium delivers lower doses to surrounding healthy tissues.

    Conclusions:

    • This custom 192Iridium wire brachytherapy technique allows for case-specific customization and access to posterior tumor sites.
    • The afterloading approach significantly enhances radiation safety for medical staff.
    • The method achieves a beneficial depth-to-surface dose ratio, crucial for effective tumor treatment while sparing ocular structures.