TY - JOUR
T1 - Brachytherapy Future Directions
AU - Cunha, J. Adam Martin
AU - Flynn, Ryan
AU - Bélanger, Cédric
AU - Callaghan, Cameron
AU - Kim, Yusung
AU - Jia, Xun
AU - Chen, Zhe
AU - Beaulieu, Luc
N1 - Publisher Copyright:
© 2019
PY - 2020/1
Y1 - 2020/1
N2 - Brachytherapy has advanced dramatically in the last decade due largely to improvements in applicators, imaging, treatment planning, and use of clinical trials. In addition, current research in brachytherapy technology continues to change how we deliver this treatment modality. The future of brachytherapy lies in the ability of new technologies to overcome real or perceived barriers. The focus for this manuscript is on specific tools that have or are near to being introduced in the clinic. First, we explore the impact electromagnetic tracking technologies can have on brachytherapy implants and planning workflow. This is followed by an overview of the use of 3D printing and its ability to help tailor brachytherapy implants. Next, we discuss advances in self-shielded applicators and intensity-modulated brachytherapy technology. The manuscript closes out with 2 sections on treatment planning. First is a discussion of biological optimization and its potential as compared with current techniques (eg, based on physical dosimetry). And lastly, a section on optimization treatment planning efficiencies in which we explore the potential for machine learning in brachytherapy. As recent clinical evidence continues to show excellent outcomes, this is an exciting time to practice brachytherapy. With the new technologies presented here, the future is even brighter.
AB - Brachytherapy has advanced dramatically in the last decade due largely to improvements in applicators, imaging, treatment planning, and use of clinical trials. In addition, current research in brachytherapy technology continues to change how we deliver this treatment modality. The future of brachytherapy lies in the ability of new technologies to overcome real or perceived barriers. The focus for this manuscript is on specific tools that have or are near to being introduced in the clinic. First, we explore the impact electromagnetic tracking technologies can have on brachytherapy implants and planning workflow. This is followed by an overview of the use of 3D printing and its ability to help tailor brachytherapy implants. Next, we discuss advances in self-shielded applicators and intensity-modulated brachytherapy technology. The manuscript closes out with 2 sections on treatment planning. First is a discussion of biological optimization and its potential as compared with current techniques (eg, based on physical dosimetry). And lastly, a section on optimization treatment planning efficiencies in which we explore the potential for machine learning in brachytherapy. As recent clinical evidence continues to show excellent outcomes, this is an exciting time to practice brachytherapy. With the new technologies presented here, the future is even brighter.
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U2 - 10.1016/j.semradonc.2019.09.001
DO - 10.1016/j.semradonc.2019.09.001
M3 - Article
C2 - 31727305
AN - SCOPUS:85073069055
SN - 1053-4296
VL - 30
SP - 94
EP - 106
JO - Seminars in Radiation Oncology
JF - Seminars in Radiation Oncology
IS - 1
ER -