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Reducing radiotherapy dose in early breast cancer: the concept of conformal intraoperative brachytherapy

Meyerstein Institute of Oncology and Academic Department of Surgery, University College London Hospitals NHS Trust, London, UK

View larger version (24K): [in a new window]   Figure 1. The Photon Radiosurgery system (PRS). The electrons are generated and accelerated in the main unit (seen in Figure 3) and travel via the electron beam drift tube, which is surrounded by the conical applicator sheath such that its tip lies at the epicentre of the applicator sphere. Once the electrons hit the inner surface of the hemisphere at the tip, X-rays are generated. Thus, a uniform radiation dose rate is available at the surface of the applicator sphere. There is a small, very high dose region close to the applicator, which attenuates quickly (a x 1/r3).

View larger version (130K): [in a new window]   Figure 2. The applicator being placed in the tumour bed, immediately after excision of the tumour.

View larger version (122K): [in a new window]   Figure 3. The Intrabeam system with the X-ray source in the breast wound and the electron generator and accelerator held by the articulated arm. Figure 2 demonstrates how the target breast tissue wraps around the applicator giving true conformal brachytherapy.