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Vienna, Austria

ESTRO 2023

Session Item

Monday
May 15
15:00 - 16:15
Strauss 1
What can EBRT learn from brachytherapy and vice versa?
Kari Tanderup, Denmark;
Shirin A. Enger, Canada
During the last decades radiotherapy has significantly challenged dogmas on radiotherapy dose, volume and fractionation. New radiotherapy approaches are using risk-adapted dose-volume modulation, and new fractionation schedules are continuously emerging. Furthermore, artificial intelligence helps to improve our workflows and to manage complex processes. EBRT and brachytherapy differ substantially with regard to dose distribution, volume selection, fractionation and workflow. Maybe these differences can inspire us to look for new avenues? Join this symposium and become inspired to transport new knowledge and insights between two radiotherapy modalities that have each demonstrated their value for treatment of cancer across more than 100 years.
Symposium
Physics
15:00 - 15:18
High dose to a small volume - Is brachytherapy the best SBRT?
Frank-André Siebert, Germany
SP-0859

Abstract

High dose to a small volume - Is brachytherapy the best SBRT?
Authors:

Frank-André Siebert1

1UKSH, Campus Kiel, Clinic of Radiotherapy, Kiel, Germany

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Abstract Text

Stereotactic body radiotherapy (SBRT) is a method of external beam radiotherapy in which a high dose of radiation is delivered precisely to an extracranial target in one or a few treatment fractions. It is similar to brachytherapy (BT) in most respects, except that BT is not an external beam procedure. In this presentation, similarities and differences between BT and SBRT will be highlighted. An important issue is the comparison of physical doses, as both techniques can deliver high, often inhomogeneous doses to a small volume. Motion management is also important, as doses should be delivered with high dose gradients. Here, BT has an advantage because the applicators and radiation source are directly connected to the patient and movements do not have a major impact on the treatment.
Both techniques can be used adaptively, i.e., 3D imaging is performed immediately before irradiation, and the treatment plan is adjusted accordingly. Adaptive treatment of prostate cancer and cervical cancer has been used in BT for many years; for SBRT, this is still a challenge, but is already well possible with dedicated treatment devices for adaptive irradiation.
Another issue that should be considered is the integral dose. Due to the physical properties of high-energy photon beams, SBRT exposes a large volume of the patient to a low dose. This volume is lower with BT and therefore beneficial to the patient as secondary malignancies are likely to be reduced.