A feasibility study to investigate the introduction of HDR intraluminal brachytherapy for oesophageal cancer at university hospital galway

Abstract

Intraluminal high-dose rate (HDR) brachytherapy is considered to be one of the most valuable options for the treatment of oesophageal cancer. This radiotherapy technique involves the insertion of specific types of plastic applicators into the body through the oesophagus. The aim of this project is to assess the feasibility of establishing an HDR intraluminal brachytherapy procedure for oesophageal cancer at University Hospital Galway (UHG). Commissioning was performed for applicators with diameters of 8 mm, 12 mm, and 14 mm. Applicators were provided by Varian Medical Systems. The most distal position of each applicator was determined using a gafchromic film (EBT3). Within this context, there is a dead space for each bougie where the source cannot be loaded. Consequently, the first position available is determined from the end of the dead space. The dead space for the applicators of 8, 12 and 14 mm diameter was found to be at 10 cm, 15 cm and 17 cm from the tip of each applicator, respectively. The most distal source position of the bougies (with diameters of 8 mm, 12 mm or 14 mm) was found to be 50 mm from the end of the dead space. Successful collaboration among specialists working in enormously diverse disciplines (e.g., radiation physicists, oncologists, nurses, and therapists) is the fundamental aspect that will determine the success of establishing HDR intraluminal brachytherapy at UHG. Structures must be developed to assist everyone working in these diverse disciplines to coordinate and safely implement this procedure.