Abstract
BackgroundSkin tumors are the most predominant form of cancer in the United States. Radiation therapy, particularly high dose-rate (HDR) brachytherapy, provides an effective form of cancer control when surgery is not possible or when surgical margins are incomplete. The treatment of superficial skin cancers on irregular surfaces, such as the nose, lips or ears, present challenges for treatment. To address this issue, we designed and constructed a novel conformal superficial brachytherapy (CSBT) device prototype to improve patient-specific treatment for complex sites. The device is mounted on an automated remote after-loader, providing limited radiation exposure to operating personnel, is inexpensive to construct, and offers a unique method of conformal surface radiation therapy.ResultsA prototype of the CSBT device was successfully manufactured. A computed tomography (CT) scan of a Rando phantom was used to plan the target treatment area. The CSBT device has a hexagonal lattice array of retractable rods with radioactive seeds placed at the tip of each rod. A 3D-printed conformal shape insert with a hexagonal array of cylindrical projections of varying length is driven into the rods by a single linear actuator. The rods are displaced to conform to the patient’s skin. This elegant device design permits the delivery of radiation to complex targets using readily available beta-emitting radionuclides, such as Yttrium-90 (Y-90) or Strontium-90 (Sr-90).ConclusionA working prototype of a novel CSBT device was built using 3D-printing technology that provides a safe and economically attractive means of improving radiation delivery to complex treatment sites.
Highlights
Skin tumors are the most predominant form of cancer in the United States
The ability to balance treatment efficacy and normal tissue complications is of fundamental importance in radiation oncology and an adjustable brachytherapy device that uniquely conforms to each patient is necessary, given wide variation in human anatomy
In this work we describe the mechanism of action of a novel conformal superficial brachytherapy (CSBT) applicator (Fig. 1)
Summary
Skin tumors are the most predominant form of cancer in the United States. Radiation therapy, high dose-rate (HDR) brachytherapy, provides an effective form of cancer control when surgery is not possible or when surgical margins are incomplete. The treatment of superficial skin cancers on irregular surfaces, such as the nose, lips or ears, present challenges for treatment To address this issue, we designed and constructed a novel conformal superficial brachytherapy (CSBT) device prototype to improve patient-specific treatment for complex sites. Brachytherapy, or short distance RT delivered with the use of radioisotopes, has improved the ability to treat smaller skin fields, but do not conform well to uneven surfaces, such as the eyes, lips, and nose [14]. This may result in the inclusion of additional normal tissue in the radiation field to ensure good dose is administered to tumor, which can increase radiation toxicity and long-term cosmesis. The ability to balance treatment efficacy and normal tissue complications is of fundamental importance in radiation oncology and an adjustable brachytherapy device that uniquely conforms to each patient is necessary, given wide variation in human anatomy
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