Brachytherapy procedure and treatment

Brachytherapy is a form of radiotherapy where a radiation source is placed inside or next to the area requiring treatment. In case of cervical cancer, the conductors (applicators), through which radiation sources are delivered, are inserted directly into the cervix and uterus. This invasive procedure lasting for about two hours is conducted under spinal anesthesia.

Cervical cancer is more likely to develop in young women, aged 30-40 years. One of the main factors leading to the development of the disease is the papilloma virus.

A radical surgery, resulting in complete recovery, can be performed at the early stages of the disease. However, in most cases, the tumor is diagnosed at an inoperable stage, in which case radio chemotherapy is given to the patients.

Radiotherapy is divided into two stages. The first one is a remote radiotherapy using a linear accelerator with treatment sessions 5 times per week for 5-6 weeks, combined with weekly chemotherapy sessions. By the end of the remote radiotherapy course, internal radiotherapy, called brachytherapy, is added.

Sessions are held 1-2 times a week, for a total of 4 – 5 times.

The combination of the two methods yields excellent outcomes, in most cases a complete cure.

There is another type of gynecological brachytherapy involving fine needle catheters inserted directly into the tumor. This treatment procedure is indicated for women with tumor recurrence after surgery, if the local spread of the tumor no longer allows the use of the “classical” brachytherapy method.

These procedures are CT -guided and performed by specially trained professionals. The radiotherapy treatment is planned with the help of the most advanced medical imaging techniques – MRI and PET-CT.

The staff develops a new treatment plan that is personalized to each person’s conditions, which allows to achieve truly impressive results in treating cervical cancer patients.

Radiation is emitted from a radioactive source (iridium isotope 192), which is stored in a shielded safe. The isotope is delivered to the target organ via the applicators. Guidance accuracy is ensured by real-time medical imaging – the method which enables a very high dose of radiation to be delivered in minutes.

Most gynecological oncological patients need brachytherapy at various stages of treatment – before, after or instead of the surgery.

The use of internal radiation provides higher rates of cancer-specific (64% versus 52%) and overall (58% versus 46%) four-year survival.

Sophisticated 3D medical imaging and treatment planning have improved local tumor control using brachytherapy, as well as overall survival in women with malignant genital tumors. Moreover, such impressive results are accompanied by reduced toxicity and better life quality.

In conclusion, brachytherapy is an essential key component of the treatment program for patients with genital cancer. The benefits and advantages of this method cannot be overestimated.

In Tel Aviv Sourasky Medical Center, brachytherapy procedures are performed using the latest Varian’s HDR BRAVOS system under the supervision of Dr. Tatyana Rabin.