Abstract
The purpose of this study is to discuss how to use an external radio-opaque template in the Diffusing Alpha-emitters Radiation Therapy (DaRT) technique's pre-planning and treatment stages. This device would help to determine the proper number of sources for tumour coverage, accounting for subcutaneous invasion and augmenting DaRT safety. The procedure will be carried out in a first phase on a phantom and then applied to a clinical case. A typical DaRT procedure workflow comprises steps like tumour measurements and delineation, source number assessment, and therapy administration. As a first step, an adhesive fiberglass mesh (spaced by 2 mm) tape was applied on the skin of the patient and employed as frame of reference. A physician contoured the lesion and marked the entrance points for the needles with a radio opaque ink marker. According to the radio opaque marks and metabolic uptake the clinical target volume was defined, and with a commercial brachytherapy treatment planning system (TPS) it was possible to simulate and adjust the spatial seeds distribution. After the implant procedure a CT was again performed to check the agreement between simulations and seeds positions. With the procedure described above it was possible to simulate a DaRT procedure on a phantom in order to train physicians and subsequently apply the novel approach on patients, outlining the major issues involved in the technique. The present work innovates and supports DaRT technique for the treatment of cutaneous cancers, improving its efficacy and safety.
Highlights
The current standard of care for cutaneous squamous cell skin carcinoma is surgical excision, which involves removing the tumour while leaving a margin of healthy skin
The efficacy of Diffusing Alpha-emitters Radiation Therapy (DaRT) was proven in a series of preclinical studies on tumours with different histology such as squamous cell, colon, breast, pancreas, lung, and prostate carcinoma [9,10]
Tumour abolition by alpha DaRT resulted in activation of specific anti-tumour immunity [11] and an abscopal effect in one patient [12]
Summary
The current standard of care for cutaneous squamous cell skin carcinoma (cSCC) is surgical excision, which involves removing the tumour while leaving a margin of healthy skin. If surgery is not an option or is not viable or ineffective due to tumour resistance, gamma or beta-based external beam radiation and brachytherapy can be used as alternatives [1–6]. These techniques may be ineffective due to hidden tumour invasion or radio resistance [7]. The efficacy of DaRT was proven in a series of preclinical studies on tumours with different histology such as squamous cell, colon, breast, pancreas, lung, and prostate carcinoma [9,10]. Tumour abolition by alpha DaRT resulted in activation of specific anti-tumour immunity [11] and an abscopal effect in one patient [12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
