Skip to main content
main-content

01.12.2015 | Research | Ausgabe 1/2015 Open Access

Radiation Oncology 1/2015

Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy

Zeitschrift:
Radiation Oncology > Ausgabe 1/2015
Autoren:
Sandra Sarmento, Filipa Costa, Alexandre Pereira, Joana Lencart, Anabela Dias, Luís Cunha, Olga Sousa, José Pedro Silva, Lúcio Santos
Wichtige Hinweise
An erratum to this article can be found at http://​dx.​doi.​org/​10.​1186/​s13014-015-0565-7.
An erratum to this article is available at http://​dx.​doi.​org/​10.​1186/​s13014-015-0565-7.

Competing interests

The authors report no conflicts of interest in this work.

Authors’ contributions

LS conceived and organized the study, with some input from OS and JPS. SS, FC and AP carried out the measurements. SS, FC, AP, JL, AD and LC were responsible for data analysis and interpretation. FC, SS and LS reviewed the literature. SS and FC drafted the first version of the manuscript. AP, JL, AD, LC, OS, JPS and LS revised the manuscript critically for important intellectual content. All authors read and approved the final manuscript.

Abstract

Background

Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT.

Methods

CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber.

Results

Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR 192Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT.

Conclusion

The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR 192Ir brachytherapy.
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 1/2015

Radiation Oncology 1/2015 Zur Ausgabe

Neu im Fachgebiet Onkologie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Onkologie und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise