Novel Use of the Contura for High Dose Rate Cranial Brachytherapy

Scanderbeg, Daniel J.; Alksne, John F.; Lawson, Joshua D.; Murphy, Kevin T.

doi:10.1016/j.meddos.2010.08.001

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Volume 36, Issue 4 , Pages 344-346, Winter 2011

Novel Use of the Contura for High Dose Rate Cranial Brachytherapy

Daniel J. Scanderbeg, Ph.D.
- Department of Radiation Oncology, University of California at San Diego, La Jolla, CA
- Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Comprehensive Cancer Center, University of California at San Diego, La Jolla, CA
- Reprint requests to: Daniel J. Scanderbeg, Ph.D., Department of Radiation, Oncology, UCSD Moores Cancer Center, 3855 Health Sciences Dr. #0843, La Jolla, CA 92093-0843
John F. Alksne, M.D.
- Division of Neurological Surgery, University of California at San Diego, La Jolla, CA
Joshua D. Lawson, M.D.
- Department of Radiation Oncology, University of California at San Diego, La Jolla, CA
- Center for Advanced Radiotherapy Technologies, Rebecca and John Moores Comprehensive Cancer Center, University of California at San Diego, La Jolla, CA
Kevin T. Murphy, M.D.
- Department of Radiation Oncology, University of California at San Diego, La Jolla, CA

Received 26 February 2010; accepted 16 August 2010. published online 09 December 2010.

Abstract

A popular choice for treatment of recurrent gliomas was cranial brachytherapy using the GliaSite Radiation Therapy System. However, this device was taken off the market in late 2008, thus leaving a treatment void. This case study presents our experience treating a cranial lesion for the first time using a Contura multilumen, high-dose-rate (HDR) brachytherapy balloon applicator. The patient was a 47-year-old male who was diagnosed with a recurrent right frontal anaplastic oligodendroglioma. Previous radiosurgery made him a good candidate for brachytherapy. An intracavitary HDR balloon brachytherapy device (Contura) was placed in the resection cavity and treated with a single fraction of 20 Gy. The implant, treatment, and removal of the device were all completed without incident. Dosimetry of the device was excellent because the dose conformed very well to the target. V90, V100, V150, and V200 were 98.9%, 95.7%, 27.2, and 8.8 cc, respectively. This patient was treated successfully using the Contura multilumen balloon. Contura was originally designed for deployment in a postlumpectomy breast for treatment by accelerated partial breast irradiation. Being an intracavitary balloon device, its similarity to the GliaSite system makes it a viable replacement candidate. Multiple lumens in the device also make it possible to shape the dose delivered to the target, something not possible before with the GliaSite applicator.

Key Words: Cranial brachytherapy, High-dose-rate brachytherapy, Contura, Recurrent gliomas