S32
Brachytherapy - General brachytherapy
ESTRO 2026
common lower-grade acute toxicities were pollakisuria and/or dysuria (50%), pain (41.7%) and radiation dermatitis (33.3%) (Figure 1).
Digital Poster 593 Personalization of commercial applicators for brachytherapy in challenging cases: Feasibility and tolerability based on our clinical experience Irma Telarovic 1 , Michael Baumgartl 1 , Klara Kefer 1 , Silvia Fabiano 1 , Matteo Bagnalasta 1 , Stephanie Tanadini- Lang 1 , Esmee Looman 1 , Markus Vogt 1 , Floor Coremans 1 , Filippo Sturnig 1 , Alessandro Mencarelli 1 , Melissa Ann Senning 1 , Aleksandar Radomirovic 1 , Primoz Petric 2 , Panagiotis Balermpas 1 , Nicolaus Andratschke 1 , Matthias Guckenberger 1 , Laura Motisi 1 1 Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland. 2 Department of Radiation Oncology, Cantonal Hospital of Lucerne, Lucerne, Switzerland Purpose/Objective: Brachytherapy enables the delivery of high doses of radiation from the inside of the involved anatomical area, while sparing the surrounding healthy tissues. This treatment is technically feasible particularly when the implantation site is accessible to commercially available pre-manufactured applicators. However, sometimes, despite the integrated modularity, these devices may not be suitable for, or adaptable to, the specific site of implantation. Here we report our preliminary clinical experience with cases in which an adaptation and customization of pre-manufactured applicators was necessary in order to optimize brachytherapy treatment. Material/Methods: From January 2023 until June 2025, 12 patients were treated using personalized applicators at our institution. Data on patient and treatment characteristics, and acute toxicity was retrospectively collected. For patients with a follow-up time of at least 6 months (n=7), we additionally assessed the treatment outcome and late toxicity. Results: 10 female and 3 male patients with a median age at diagnosis of 60yo (range: 42-82) were included. Gynecological cancer was most common (n=7, 58.3%), followed by nasal cancer (n=2, 16.7%), and single cases of penile cancer, basal cell carcinoma and metastatic melanoma. Reasons for personalization included uncommon tumor locations (33.3%), anatomical variations (16.7%), and anatomical changes due to the tumor (25%) or previous medical treatment (25%). The majority of patients (58.3%) received a combined intracavitary (IC) and interstitial (IS) treatment. All patients successfully completed the treatment as planned. No complications, in particular bleeding or infections were observed. Prophylactic antibiotics were prescribed for patients receiving IS therapy. Implant removal was uneventful, and no high-grade acute toxicities (CTCAE >=3) were observed. Most
Commercial applicators were personalized using easily accessible and affordable, CE-certified medical devices, for which no additional legal certification is required (e.g. Nelaton female catheter, Rapid Rhino nasal catheter). Figure 2A shows an applicator for nasal vestibule carcinoma. Inflatable hemostatic tamponade device is used to position and fix disposable plastic catheters, used for needle insertion. Figure 2B shows a personalized applicator for a vaginal vault melanoma. Disposable plastic catheters are secured within a commercial ring applicator, whereby the central catheter simulates the tandem.
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