BRACHYTHERAPY Edited by Kazushi Kishi Brachytherapy Edited by Kazushi Kishi Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Vana Persen Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published April, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechopen.com Brachytherapy, Edited by Kazushi Kishi p. cm. ISBN 978-953-51-0602-9 Contents Preface IX Section 1 In Physics of Brachytherapy 1 Chapter 1 A Review on Main Defects of TG-43 3 Mehdi Zehtabian, Reza Faghihi and Sedigheh Sina Chapter 2 Dose Calculations of the Ru/Rh-106 CCA and CCB Eyes Applicators 17 Itzhak Orion and Emanuel Rubin Section 2 Californium 31 Chapter 3 Progress in Californium-252 Neutron Brachytherapy 33 C K. Chris Wang Section 3 Practice of Brachytherapy 59 Chapter 4 Theoretical, Manufacturing and Clinical Application Aspects of a Prostate Brachytherapy I-125 Source in Brazil 61 Carlos A. Zeituni, Carla D. Souza, Eduardo S. Moura, Roberto Kenji Sakuraba, Maria Elisa C.M. Rostelato, Anselmo Feher, João A. Moura, Samir Somessari and Osvaldo L. Costa Chapter 5 High Dose Rate Endobronchial Brachytherapy in Lung Cancer in Patients with Central Airway Obstruction 79 Alejandro B. Santini, Benjamín G. Bianchi, Dionis D. Isamitt, Claudia C. Carvajal and Gonzalo P. Silva Section 4 Novel Strategy and Applications 89 Chapter 6 Stereotactic Brachytherapy for Brain Tumors 91 Maximilian I. Ruge, Stefan Grau, Harald Treuer and Volker Sturm VI Contents Chapter 7 Safe and Curative Brachytherapy Reirradiation with Organ-Sparing Hyaluronate Gel Injection 109 Kazushi Kishi, Yasutaka Noda and Morio Sato Preface Science of brachytherapy is currently increasing in the field of cancer therapy. By virtue of the development of computer assisted technologies, we can reap the benefits of accurate radiotherapies more than ever, which enabled precise irradiation to a target safely avoiding unnecessary involvement of the surrounding normal tissue. Unlike teleradiotherapy provided by X-ray linear accelerator, brachytherapy utilizes radiation source placing inside or close to the target. Taking advantage of practical availability of the physical characters including decay modes, half-lives, and decay energies of the radioisotopes, various practical insertion or deployment methods have been developed. Some of these are technically sophisticated. A precise treatment planning requires accurate dose calculation algorithm even in brachytherapy. In the clinical practice of brachytherapy, safe interventional procedures are indispensable. Reverse, a simultaneous intervention modifying the surrounding structure may be practically applicable. In the first section, In Physics of Brachytherapy, Zehtabian et al. addresses the problem of currently popular dosimetric method (AAPM TG-43) based on experimental data. Orion et al. reports a potential benefit of Monte Carlo method in dose calculations of ruthenim-106/rhodium-106 (beta emitters) eyes applicators. In the second section, Californium, Wang present an excellent review of Progress in Californium-252 (Cf-252) Neutron Brachytherapy, including history, availability, fabrication, biological basis, dosimetry and clinical data including promising future possibilities. In the third section, Practice of Brachytherapy, Santini et al. reports their clinical case series study of high dose rate endobronchial brachytherapy in central airway tumor obstruction. Impressive result indicate a singinficant rationale of brachytherapy in this situation. Zeituni et al. elaborate a comprehensive review from principle and techniques of Iodine-125 production at nuclear reactor plant to their clinical practive in prostate cancer treatment. In the last section, Novel Strategy and Applications, Ruge et al present a very interesting review with their clinical practices of Stereotactic Brachytherapy for Brain Tumors using Iodine-125 seed. We may reappraise our current concepts in the treatment of gliomas that has never been satisfactory controlled. In the last chapter, Kishi et al introduce a brachytherapy procedure with organ-sparing hyaluronate gel injection as a simultaneous intervention, which enabled safe and eradicative reirradiation, by modifying the surrounding structure during the irradiation. X Preface Though this book is not an unabridged review of brachytherapy, it is full of essences to make a breakthrough in radiation oncology by brachytherapy. I hope this book will encourage all people from related fields. Acknowledgement I would like to thank all contributors, all people related and especially Ms. Vana Persen, the wonderful Publishing Process Manager, my mentors, and my family who have supported me throughout the term. Dr Kazushi Kishi M.D., Ph.D., Department of Radiology, Wakayama Medical University, Japan . BRACHYTHERAPY Edited by Kazushi Kishi Brachytherapy Edited by Kazushi Kishi Published by InTech Janeza Trdine 9, 51000 Rijeka,. orders@intechopen.com Brachytherapy, Edited by Kazushi Kishi p. cm. ISBN 978-953-51-0602-9 Contents Preface IX Section 1 In Physics of Brachytherapy 1 Chapter 1. Gel Injection 109 Kazushi Kishi, Yasutaka Noda and Morio Sato Preface Science of brachytherapy is currently increasing in the field of cancer therapy. By virtue of the development