Initial experience of a nationwide ruthenium‐106 and iodine‐125 ocular brachytherapy service in Ireland

• Published in: Acta ophthalmologica (Oxford, England) England), 2011-09, Vol.89 (s248), p.0-0
• Main Authors: WALKER, C, LANGAN, B, HORGAN, N, CUNNINGHAM, M, GRUNNER, E, MCCLEAN, B
• Format: Article
• Language: English
• Subjects: Brachytherapy; Iodine; Patients; Plaques; Radiation therapy; Tumors
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2011.442.x

Purpose St. Lukes Hospital, Rathgar, Dublin 6, Ireland has recently implemented an Ocular Brachytherapy Service using both Ruthenium‐106 and Iodine‐125 plaques. This work will summarize the initial experience of the hospital in these treatment modalities and provide information on some of the challenges experienced by a new centre performing this technique. Outline plans for the future of the service will also be presented. Methods Between September 2010 and June 2011, twenty six patients received a plaque treatment at St. Lukes Hospital. Six of these were Iodine‐125 cases, while twenty used Ruthenium‐106. A multi‐disciplinary pre‐planning procedure using BEBIGs "Plaque Simulator" software identifies treatment durations. This group consists of a Physicist, Consultant Ophthalmologist and a Consultant Radiation Oncologist with the goal of fitting both plaque insertions & removals into designated weekly theatre slots. Following this, a comprehensive plancheck analysis is performed. Post‐treatment, a delivered plan is generated by a Physicist and signed by the clinical team. A yearly delivery of Ruthenium plaques is scheduled; information is given on plaque types, number of uses and plans for Year Two. NPL calibrations were used as a second‐check in Year One with an in‐house method involving a stereotactic diode proposed for Year Two. Results Nine months into the program, tumour regression in the initial patients is already being observed. Procedures have been streamlined to satisfy designated theatre slots where possible and to maximise throughput of patients. A second‐check calculation procedure for Ruthenium plaques has been devised; however the long‐term plan proposes a greater proportion of Iodine treatments due to the timing flexibility this provides. The in‐house method of calibration shows promise, however further investigations are required before it is suitable for clinical use. This work is ongoing. Conclusion An Ocular Brachytherapy service has been successfully implemented in St Lukes Hospital that is providing both Ruthenium‐106 and Iodine‐125 treatments to patients across the Republic of Ireland. As the service matures and further intra‐departmental training takes place, the facility will be well prepared to handle both an increase in capacity and complexity while performing treatments to a high standard.