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2/2025
vol. 17
abstract:
Original paper
Quality control strategies for head and neck brachytherapy (interventional radiotherapy)
Valentina Lancellotta
1
,
Patrizia Cornacchione
2
,
Víctor González-Pérez
7
,
Mariangela Massaccesi
6
,
Maria Antonietta Gambacorta
6, 9
,
- UOC Degenze di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- UOC Fisica per le Scienze della Vita, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
- Medical Physics Unit, Bambino Gesù Children’s Hospital IRCCS, Rome, Italy
- Sezione di Fisica, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC Servizio di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini e Radioterapia Oncologica, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Department of Medical Physicist, IVO Foundation, Valencia, Spain
- UOC Di Radioterapia Oncologica, Ospedale Isola Tiberina Gemelli Isola, Rome, Italy
- Sezione di Radiologia, Università Cattolica del Sacro Cuore, Rome, Italy
- UOC di Otorinolaringoiatria, Dipartimento di Scienze dell’Invecchiamento Neurologiche Ortopediche e del Testa-Collo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Sezione di Otorinolaringoiatria, Università Cattolica del Sacro Cuore, Rome, Italy
- Otorhinolaryngology Division, Azienda Ospedaliero Universitaria Sassari, 07100 Sassari, Italy
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy
J Contemp Brachytherapy 2025; 17, 2: 127–132
Online publish date: 2025/04/28
Purpose:
This study aimed to investigate quality control (QC) strategies to enhance treatment delivery in interventional radiotherapy (IRT) for head and neck (H&N) cancers, focusing on ensuring the accuracy of therapy while addressing specific challenges, such as catheter displacement and tube misconnection.
Material and methods:
A retrospective analysis was conducted among 30 patients treated with IRT for nasal vestibule or eyelid cancers at our institutional center from January 2022 to December 2023. All treatments involved 14 fractions over nine days. QC measures were implemented to monitor catheter placement and prevent misconnection, with daily visual checks and mid-course CT evaluations. Distance measurements between catheter markers were compared across scans, and variations exceeding 2 mm prompted re-planning. Statistical analyses included one-way t tests to assess marker displacement significance.
Results:
A total of 420 fractions were delivered, and 360 marker distance measurements were analyzed. No significant differences were observed between initial and mid-course CT scans (mean distances, 35.2 ±10.5 mm and 35.9 ±10.5 mm, respectively). However, in 16.6% of cases, re-planning was required due to catheter displacement or marker variation exceeding 2 mm. Notably, patients with nasal vestibule cancers demonstrated higher number of catheters and increased risk of displacement. Dosimetric evaluation confirmed significant dose distribution changes in a sub-set of cases, highlighting the clinical importance of QC.
Conclusions:
Quality control strategies are essential to ensure precise treatment delivery in H&N IRT, especially in complex anatomical sites and risk of catheter displacement. Implementation of systematic checks and re-planning criteria enhances patient safety and treatment efficacy. Further research is warranted to refine QC measures and evaluate their impact on clinical outcomes.
keywords:
brachytherapy, quality assurance, interstitial brachytherapy, interventional radiotherapy
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