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Radiation Oncology
Published in: Radiation Oncology 1/2015

Open Access 01-12-2015 | Research

Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy

Authors: Sandra Sarmento, Filipa Costa, Alexandre Pereira, Joana Lencart, Anabela Dias, Luís Cunha, Olga Sousa, José Pedro Silva, Lúcio Santos

Published in: Radiation Oncology | Issue 1/2015

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Abstract

Background

Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT.

Methods

CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber.

Results

Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR 192Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT.

Conclusion

The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR 192Ir brachytherapy.
Literature
1.
Calvo F, Meirino RM, Orecchia R. Intraoperative radiation therapy first part: rationale and techniques. Crit Rev Oncol Hematol. 2006;59:106–15.CrossRefPubMed
2.
Edwin M, Anderson J. The dosimetric properties of an applicator system for intraoperative electron-beam therapy utilizing a Clinac-18 accelerator. Med Phys. 1981;9:261–8.
3.
Martinez-Monge R, Nag S, Martin EW. Three Different Intraoperative Radiation Modalities (Electron Beam, High-Dose-Rate Brachytherapy, and Iodine-125 Brachytherapy) in the Adjuvant Treatment of Patients with Recurrent Colorectal Adenocarcinoma. Cancer. 1999;86:236–47.CrossRefPubMed
4.
Hashiguchi Y, Sekine T, Sakamoto H, Tanaka Y, Kazumoto T, Kato S, et al. Intraoperative irradiation after surgery for locally recurrent rectal cancer. Dis Colon Rectum. 1999;42:886–93. discussion 893–5.CrossRefPubMed
5.
Birth M, Figueras J, Bernardini S, Troen T, Günther K, Mirza D, et al. Collagen fleece-bound fibrin sealant is not associated with an increased risk of thromboembolic events or major bleeding after its use for haemostasis in surgery: a prospective multicentre surveillance study. Patient Saf Surg. 2009;3:13.PubMedCentralCrossRefPubMed
6.
Rickenbacher A, Breitenstein S, Lesurtel M, Frilling A. Efficacy of TachoSil a fibrin-based haemostat in different fields of surgery - a systematic review. Drug Eval. 2009;9:897–907.
7.
Tinelli A, Mynbaev O, Tsin D, Giorda G, Malvasi A, Guido M, et al. Lymphocele prevention after pelvic laparoscopic lymphadenectomy by a collagen patch coated with human coagulation factors: a matched case–control study. Int J Gynecol Cancer. 2013;23:956–63.CrossRefPubMed
8.
9.
Mutic S, Palta JR, Butker EK, Das IJ, Huq MS, Loo L-ND, et al. Quality assurance for computed-tomography simulators and the computed-tomography-simulation process: Report of the AAPM Radiation Therapy Committee Task Group No. 66. Med Phys. 2003;30:2762.CrossRefPubMed
10.
Low DA, Harms WB, Mutic S, Purdy JA. A technique for the quantitative evaluation of dose distributions. Med Phys. 1998;25:656–61.CrossRefPubMed
11.
Federal Drug Administration. TachoSil (Absorbable Fibrin Sealant Patch) Prescribing Information. In: Initial US approval. 2010.
12.
International Atomic Energy Agency. Trends in Radiation Sterilization of Health Care Products. Vienna, Austria; 2008.
13.
Palta JR, Biggs PJ, Hazle JD, Huq MS, Dahl RA, Ochran TG, et al. Intraoperative electron beam radiation therapy: technique, dosimetry, and dose specification: report of task force 48 of the radiation therapy committee, american association of physicists in medicine. Int J Radiat Oncol Biol Phys. 1995;33:725–46.CrossRefPubMed
14.
Beddar AS, Biggs PJ, Chang S, Ezzell GA, Faddegon BA, Hensley FW, et al. Intraoperative radiation therapy using mobile electron linear accelerators: report of AAPM Radiation Therapy Committee Task Group No. 72. Med Phys. 2006;33:1476–89.CrossRefPubMed
15.
Nairz O, Deutschmann H, Kopp M, Wurstbauer K, Kametriser G, Fastner G, et al. A dosimetric comparison of IORT techniques in limited-stage breast cancer. Strahlenther Onkol. 2006;182:342–8.CrossRefPubMed
Metadata
Title
Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy
Authors
Sandra Sarmento
Filipa Costa
Alexandre Pereira
Joana Lencart
Anabela Dias
Luís Cunha
Olga Sousa
José Pedro Silva
Lúcio Santos
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2015
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-014-0316-1

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