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Fractionated perioperative high dose rate brachytherapy using a tissue equivalent bendy applicator

S Könemann, MD 1 K Deppe 1 A Schuck, MD 1 O Micke, MD 1 U Schäfer, MD 1 N Lindner, MD 2 A Hillmann, MD 2 K-H Dietl, MD 3 H-L Kronholz, MD 1 H Annweiler, MD 1 and N A Willich, MD 1

Departments of 1 Radiotherapy, 2 Orthopaedics and 3 Surgery, University Hospital, Münster, Germany



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  		Figure 1. Flexible, transparent, six channel tissue equivalent bendy applicator in situ after tumour resection. Note the plastic tubes for high dose rate brachytherapy.

 


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  		Figure 2. Post-operative CT scan of a patient with a retroperitoneal sarcoma after tumour resection and tissue equivalent bendy applicator (TEBA) application. Tubes used for afterloading are parallel with same distances to the TEBA surface. An additional TEBA (arrow) is used towards the intraabdominal space to keep risk structures such as intestine away. An overlay with isodoses is given. The prescription point for 5 Gy was calculated at 5 mm from the TEBA surface.

 


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  		Figure 3. Isodoses (in Gy) using the tissue equivalent bendy applicator (TEBA) method (a) in comparison to brachytherapy catheters without a spacer material (b). Dimensions are given in centimetres. Prescription point for 5 Gy is 5 mm (calculated in (a) from the surface of TEBA and in (b) from the surface of catheters).

 




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