brachytherapy in gynecological cancers, prostate and some pediatric cases

1. Brachytherapy
Dioloma
25/12/2014
Dr Belal El Hawwari
Consultant Radiation Clinical Oncologist

2. 285
450
550
769 1126
1396
3302
3354
3380
3142
3362 3412
3430
3478
3591
3678
4198
4332
4606
4798
4849
4675
0
1000
2000
3000
4000
5000
6000
1980
1983
1986
1989
1992
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Noofcases
Year
Trend of Cancer 1980-2011
Hospital-Based
Basheer
Hospital
Population-Based Registry

3. Top Ten Cancers –Males 2011
12.7 12.5
7.8 7.7
5.8
5.5
4.9
3.7 3.6
3.2

4. 37.7
9.8
5.8 5.6
4.0 4.0
2.8 2.7 2.1 2.1
0
100
200
300
400
500
600
700
800
900
1000
Top Ten Cancers –Females 2011

5. 0
10000
20000
30000
40000
50000
60000
Total Males Females
100 %
49 % 51 %
Total Registered Cancer Cases 1996-2010 (Jordanian)
N= 55000

6. External photon beam
Standard field AP/PA
Standard field Rt & L:t Lat
Extended field AP/PA
Small field AP/PA
Linear Accelerator

7. Insertion the Applicator

8. Simulation

9. High dose intracavitary brachytherapy
Afterloder HDR microselectron
(Ir 192)

10. SLEEVE

12. Planning & Dosimetry

13. Treatment

16. PROSTATE IG-HDR BRACHYTHERAPY
TRUS real-time needle position determination with “Swift”
2D 3D

18. Gynecological Template Brachytherapy
Procedural Aids
TRUS
Cystoscopy
Tandem
seeds
Fluoro
jdemanes@cetmc.com

19. Scan Based Dosimetry
3 Dimensional Treatment Planning
CTV (Physician) clinical & radiographic correlations
PTV (Dosimetry) conform isodose to target minimize normal tissue doses
jdemanes@cetmc.co

20. SYED TEMPLATE

21. Post-implant radiograph

24. Excellent function of facial nerve

25. FIBROSARCOMA 4ta recurtrence
Peri-operative 5 years later

26. Prostatic rhabdo, 14 months

29. During last HDR fraction

30. Implant removed

31. RABDO PERI-URETHRAL 13 mo