Journal of Contemporary Brachytherapy
eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
Editorial System
Submit your Manuscript
SCImago Journal & Country Rank
Search
Share:
Send email
Share:
abstract:
Original paper

A novel patient-specific solution for Merkel cell carcinoma in high-dose-rate brachytherapy

Wei Nie
1
,
Xiaofeng Zhu
1
,
Gosia D’Souza
2
,
Audrey Copeland
1, 3
,
Mindy Joo
1
,
Jiajin Fan
1
,
Sarah Gao
1
,
Xing Li
1, 4

  1. Inova Schar Cancer Institute, Fairfax, VA, United States
  2. Adaptiiv Medical Technologies Inc., Halifax, NS, Canada
  3. New York University, New York, NY, United States
  4. Loyola University Chicago, Maywood, IL, United States
J Contemp Brachytherapy 2026
DOI: https://doi.org/10.5114/jcb.2026.160471
Online publish date: 2026/03/30
View full text Get citation
 
Purpose
Superficial lesions in anatomically complex areas pose challenges for conventional high-dose-rate (HDR) brachytherapy (BT) techniques. We developed a novel 3D-printed applicator tailored for hand skin cancer, and evaluated its clinical feasibility and advantages.

Material and methods
A patient with Merkel cell carcinoma of the right hand, involving the palm, dorsum, and interdigital spaces, was referred for HDR-BT. After initial CT simulation, planning target volume (PTV) was delineated and applicator structure was contoured, to comply with and encompass the PTV. Catheter channels were designed, and the applicator was fabricated as palmar and dorsal components to facilitate setup, using a stereolithography 3D printer with tissue-equivalent, bio-compatible clear resin. The patient underwent a second CT simulation with the applicator and catheters in place, and treatment planning was performed. Pre-treatment dry run confirmed source travel and catheter lengths, and treatment was delivered using a Flexitron HDR-BT afterloader.

Results
Twenty-seven catheters achieved PTV coverage of 98.6% at D90% and 96.7% at D95%, with a D0.03cc of 135.6%. Air gaps were less than 5 mm. Treatment was completed in 51 minutes with a 5 Ci iridium-192 (192Ir) source (15 minutes for setup and 36 minutes for delivery). At one-year follow-up, no recurrence or late toxicity was observed.

Conclusions
The patient-specific 3D-printed applicator was successfully applied for skin lesions unsuitable for conventional techniques. Reduced air gaps improved dose conformity, and the semi-rigid, translucent resin enhanced setup reproducibility. The workflow substantially optimized staff resources, offering HDR-BT solution for complex superficial lesions in clinics without in-house printing capabilities.

keywords:

3D-printing, skin applicator, high-dose-rate brachytherapy

  
Termedia
About us Contact
Copyright notice Privacy policy Advertising policy Contact us
Quick links
Journals Books eBooks Events
© 2026 Termedia Sp. z o.o.
Developed by Termedia.