Advances in technology have helped to pave the way for techniques like image guided brachytherapy (IGBT) that are leading to better outcomes and offering a better quality of life for patients. This will be one of the topics discussed further at the IAEA's Scientific Forum: A Decade of Action on Cancer Control and the Way Forward from 17 to 18 September.
“IGBT is a highly personalized and fine-tuned method for treating cancer that can help improve survival rates in many types of cancer, while lowering the risk of complications,” said Gustavo Sarria Bardales, Medical Director of the Radiation Therapy Department at Auna Oncosalud hospital in Peru. “With the rise in cancer cases worldwide, the use of IGBT offers safe, effective and quality treatment against some prevalent cancers, such as breast, prostate and cervical cancers. Further developing and implementing this technology is a great opportunity to expand access for more patients and provide them with effective care.”
While brachytherapy — a form of internal radiation treatment using radioactive sources — has been a common treatment for many cancers for more than 100 years, IGBT has only in the last 15 years been possible thanks to advances in medical imaging, treatment planning and dose delivery.
IGBT is designed to maximize the radiation dose to kill cancer cells while minimizing the exposure of the surrounding healthy cells. It uses detailed 3D medical images to capture organ volume changes in order to tailor and optimize brachytherapy for patients’ needs. The images show the exact size and location of a tumour and relevant organs in order for the healthcare team to precisely plan and safely place radioactive sources directly next to or inside a tumour for treatment. This placement can either be temporary, using a removable applicator containing the sources, or permanent, using sources called seeds that remain indefinitely inside the body; over time, the seeds lose their radioactivity and become harmless.
For certain cancer types, such as cervical cancer, IGBT is combined with external beam radiotherapy, while, for others, such as breast and prostate cancers, it can be used as an exclusive treatment. With IGBT, higher doses of radiation can be used for targeting a tumour directly, meaning healthy tissues receive a lower dose of radiation, as the sources are placed directly in or next to a tumour.
However, placing the sources inside a patient’s body requires expertise in various disciplines, such as surgery, imaging and contouring, and treatment planning, explained Alfredo Polo Rubio, a radiation oncologist at the IAEA. “It is not a ‘one-size-fits-all’ procedure, since each patient’s body and each tumour is different, and brachytherapy is a kind of personalized treatment. Combining brachytherapy with imaging gives the healthcare team a clearer view of the tumour and the surrounding organs and facilitates the placement of the radiation sources, assessment of tumour response and more accurate adjustment of radiation doses.”
We used to be limited to conventional 2D and 3D brachytherapy. Now we have begun using IGBT and are waiting to see the full impact of its use.
