A New Approach for a Safe and Reproducible Seeds Positioning for Diffusing Alpha-Emitters Radiation Therapy of Squamous Cell Skin Cancer: A Feasibility Study.
Giacomo FelicianiSalvatore Roberto BelliaMassimo Del DucaGiorgio MazzottiManuela MontiIgnazio StanganelliYona KeisariItzhak KelsonAron PopovtzerAntonino RomeoAnna SarnelliPublished in: Cancers (2022)
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.
Keyphrases
- radiation therapy
- minimally invasive
- primary care
- end stage renal disease
- image quality
- squamous cell
- skin cancer
- emergency department
- ejection fraction
- newly diagnosed
- high dose
- chronic kidney disease
- dual energy
- peritoneal dialysis
- computed tomography
- locally advanced
- radiation induced
- magnetic resonance imaging
- cell migration
- case report
- patient reported outcomes
- health insurance
- drinking water
- low dose
- mesenchymal stem cells
- mass spectrometry
- wound healing
- tandem mass spectrometry
- affordable care act
- liquid chromatography