Brachytherapy involves placing radioactive sources inside or near a tumor to deliver radiation therapy. It is a type of radiotherapy that allows for a high dose of localized radiation to be administered to the tumor area while sparing surrounding healthy tissues from radiation exposure. Brachytherapy treatments are typically short in duration compared to external beam radiotherapy but require specialized equipment and skilled medical professionals for administration.

1. Brachytherapy

2. • Defined as treatment of cancer by
inserting radio-active sources into or
near the tumor
• It is a type of Radiotherapy
What is Brachytherapy ?

3. Radiation Therapy
 Treatment of malignant diseases by ionizing
radiation
 Relatively a new specialty (Roentgen 1895)
 Technology oriented subject: rapid progress
 Modern RT: sophisticated and precise
 Heavy investment, regulatory authorities
 Medical fraternity : not very familiar

4. Radiation Therapy
 It is a localized form of treatment
 It is a prolonged/protracted Tt. (5-7 wks)
 It is easy to administer, specialized Tt.
 It is a painless procedure

5. Types of Radiotherapy
 Teletherapy or Ext. RT
Cobalt: Radio-active source
Linear Accelerator: X-ray source
 Brachytherapy
Manual afterloading unit
Remote afterloading Unit

6. Cobalt Teletherapy Unit

7. Linear Accelerator

9. Microselectron HDR
Selectron LDR
Microselectron PDR

10. Brachytherapy

12. Types of Brachytherapy
It can be categorized in many ways
 Location of implant
 Type of loading
 Dose rate
 Duration of implant
 Type of emission

13. Types of Brachytherapy
Location of implant
 Intracavitary: cervix, esophagus
 Interstitial: prostate, tongue
 Surface mold or Plaque: skin, palate, scalp

14. Types of Brachytherapy
Duration
 Temporary: Source is taken out after the Rx
uterus, breast
 Permanent: Permanently placed in the target
Prostate, Brain

15. Types of Brachytherapy
Method of delivery
 Manual loading: Radium needles
 Afterloading:
Manual or
Remote controlled

16. Types of Brachytherapy
dose rate
 Low Dose Rate (LDR) = 0.4-2.0 Gy/hr
 Medium Dose Rate (MDR) = 2-12 Gy/hr
 High Dose Rate (HDR) = >12 Gy/hr

17. Microselectron HDR
Selectron LDR
Microselectron PDR

19. ADVANTAGES OF BRACHYTHERAPY
 A high localized radiation dose to a small volume
--higher local control
 Spares surrounding normal organs and tissues leading to
less side effects
 Ultimate form of conformal radiotherapy
 Shorter treatment time-convenient, prevents tumor
proliferation
 Nonhomogenous dose distribution to tumor targeting the
hypoxic central core

20. EBRT Brachytherapy
Prolonged Treatment (wks) Short duration (hrs)
OPD procedure Indoor
Non-invasive Invasive
Painless Analgesia required
Tumor size : any Small
Simple Treatment Skilled
Normal tissue dose Minimal
Body movements: problem Negligible
Common use alone Often combined with EBRT
Widely available Limited availability
Heavy & costly equipment Small, cheaper

21. Breachytherapy: Team work
 Brachytherapist
 Anesthesiologist
 Medical Physicist
 Staff nurse

22. Brachytherapy Facilities in India
Radiotherapy Centres : 357
Teletherapy Facilities : 533
Brachytherapy Facilities : 343
 Remote Afterloading Units (HDR/MDR/LDR) : 227
 Manual Afterloading Brachytherapy facilities : 116

23. Common Indications
 Prostate
 Cervix
 Breast
 Head & Neck
 Sarcomas
 Esophagus
 Ano-Rectum

24. BRACHYTHERAPY IN
CARCINOMA CERVIX

25. BRACHYTHERAPY TYPES IN CA CERVIX
 Intracavitary radiotherapy (ICRT)
 Interstitial brachytherapy

29. A COMPLETED HDR ICRT APPLICATION

30. SIMULATION
Markers
Markers Orthogonal

32. COMPLETED TEMPLATE

33. IMAGING

34. Bladder
Target
Rectum

36. TREATMENT DELIVERY

37. Fig. 1
ba

43. Role of Brachytherapy in Ca Breast

44. Role of Brachytherapy in Ca Breast
 As boost treatment in BCT: After a dose of 45-50 Gy with
EBRT to the whole breast, boost dose of 15-20 Gy is
delivered by brachytherapy
 As sole modality of treatment: As sole modality of
treatment - an alternative to standard BCT in selected
patients
 For treatment of Chest wall recurrences: Chest wall
irradiation with a moulded cast/interstitial implantation
 LABC (inoperable):

49. Brachytherapy in Head and neck cancer

58. Brachytherapy in Ca Prostate

59. STEPS:
Planning-TRUS guided volume study—computer preplan
Brachytherapy procedure-TRUS guided trans perineal needle-..
peripheral loading..
seeds placed along the tract from base to apex.
Post implant evaluation-by CT scan

68. Intra-operative Brachytherapy

70. Gliasite Brachytherapy

72. Skin Cancer

73. Surface Brachytherapy

75. Brachytherapy effect

76. Role of Nursing in RT/Brachytherapy
 Clinical care : Communication; medical care; psychosocial care
 Teaching
 Research

77. Role of Nursing in RT/Brachytherapy
 Outdoor pts
 Indoor pts
 For management of pts undergoing RT
 For planned brachytherapy/IORT procedures

78. Role of Nursing in RT
 Familiar with the usual course of RT
 Instruction, precautions during RT
 Knowledge of radiation safety
 Any emergency

79. Nursing care for brachytherapy
 Limit time in pt room
 Limit visitors to 30 minutes at a 6 foot
distance
 Post radiation signs on door
 No young children or pregnant women
 Nurses wear radiation badge
 Follow policies of radiation dept

80. Conclusion
 Brachytherapy is highly precise and accurate form
of RT
 Can be done for almost every cancer site
 Small tumors are ideal lesions for cure
 Large lesions are treated by brachytherapy + EBRT
 Knowledge of brachytherapy is essential for
oncology nurses