PATIENT OPTIMIZED BRACHYTHERAPY FOR BREAST CARCINOMA

到目前为止，保乳治疗是大多数早期乳腺癌患者的首选治疗方案。肿块切除术后放射治疗的推荐选择是外照射，在某些情况下，通过近距离放射治疗增加局部剂量。避免局部复发自然是首要目标，但美容和患者舒适度至关重要。传统的192Ir金属丝和较新的125I粒子被插入到肿瘤床中，并不适合乳房近距离放射治疗。这些设备是普通产品，并不是以妇女的健康和福利为主要目标而设计的。这项应用描述了小直径柔性盘绕103Pd线源的发展，它将辐射场限制在肿瘤床及其边缘。光源的低能量将扩大使用的适应症，因为它可以用于更多浅层的肿瘤床。这将减少对患者隔离的需要。扩展的线源提供了更均匀的剂量分布，消除了热点和冷点，改善了高接触剂量和组织(脂肪)坏死的可能性。细小(0.35毫米直径)的放射源应该会改善患者的舒适度，减少疤痕组织，并改善美容效果。毫不费力的源组件将最大限度地减少对医护人员的无意接触。拟议的商业应用：近距离放射治疗在乳腺癌治疗中的作用正在演变。据报道，在其鼎盛时期，接受乳房近距离放射治疗的女性人数高达2.6万例/年。乳房近距离放射治疗的一个严重障碍是缺乏一个最佳的来源，该来源将可靠和足够的剂量提供给预期的部位，但将对邻近器官和主治医生的辐射并发症降至最低。本申请中描述的来源被认为解决了许多这些问题，并为乳房和其他器官的近距离放射治疗创造了重大机会。

Breast conserving therapy is by far the preferred choice of the majority of women with early stage breast carcinoma. The recommended options for radiation treatment following lumpectomy are external beam therapy and, in certain cases, an additional local dose by brachytherapy. Avoiding local occurrence is, naturally, the primary goal, but cosmesis and patient comfort are of critical importance. Traditional 192Ir wires and the newer 125I seeds, inserted into the tumor bed are not optimized for breast brachytherapy. These devices are generic products and were not designed with women's health and welfare as the primary objective. This application describes the development of small diameter flexible coiled 103Pd wire source that constrains radiation field to the tumor bed and its margin. The low energy of the source will broaden the indication for use, as it can be used for more superficial tumor beds. It will reduce the need for patient isolation. The extended linear source provides a more homogeneous dose distribution, eliminates hot and cold spots, ameliorates the high contact dose and the possibility of tissue (fat) necrosis. The fine (0.35-mm diameter) profile of the source should improve patient comfort, minimize scar tissue, and improve cosmesis. The effortless source assembly will minimize unintentional exposure to the health care workers. PROPOSED COMMERCIAL APPLICATIONS: The role of brachytherapy for treatment of carcinoma of the breast is evolving. At its height, the number of women receiving breast brachytherapy has been reported to be as high as 26,000 cases/year. A serious impediment for the breast brachytherapy modality has been the absence of an optimal source that delivers a reliable and adequate dose to the intended site but minimizes radiation complications to adjacent organs and attending healthcare workers. The source described in this application is believed to address many of these concerns and create major opportunity for brachytherapy of the breast and other organs.