2nd FY Khoo Memorial Lecture. Brachytherapy–one man’s meat, a personal journey in radiation oncology.

This research article is a summary of the author’s personal journey in radiation oncology, specifically with the use of brachytherapy, a type of internal radiotherapy, tracing the progression from low-dose rate treatments in the 1960s to high-dose rate remote afterloading in the 1980s and beyond.

Brachytherapy Journey

• The author begins by discussing his early experiences with brachytherapy, a radiation treatment procedure that involves placing radioactive material inside the body. This was during the 1960s and 1970s where the common practice involved the use of low-dose rate (LDR) treatments utilizing 226Ra, a radioactive isotope of radium, as “hot” sources.
• The author then transitions to the 1970s and 1980s period that saw the transition to manual afterloading for gynaecological cancers using the same hot sources. Manual afterloading is a technique where radioactive sources are placed within the body using a special applicator.
• Finally, the author talks about the current practice of high-dose rate (HDR) remote afterloading, a procedure that became popular from 1989 onwards. This process involves the use of a machine called a microSelectron HDR, which delivers a high radiation dose directly to the tumor, minimizing exposure to surrounding healthy tissues.

Cancer Treatments and Outcomes

• The author also shares specific applications of these brachytherapy techniques to various tumor sites.
• Included are the long-term results of a personal series of 106 patients suffering from uterine cervix cancer. These patients were treated with radiotherapy that incorporated HDR brachytherapy. However, details of these results were not provided in the abstract.
• The lecture concludes with a unique case of equine sarcoid, a common skin tumor in horses, treated with a postoperative implant using iodine-192 LDR brachytherapy. This case serves to illustrate the broad range of applications for brachytherapy beyond human oncology.