Brachytherapy for Other Treatment Sites

Historically, brachytherapy was used long before the development of external beam radiation kilovoltage, orthovoltage, and megavoltage machines. Radium was the most commonly used radioactive isotope and used to treat a variety of tumors and nonmalignant conditions. Brachytherapy is highly successful in the eradication of cervical cancers and other gynecological malignancies. It is, however, also used to treat several nongynecological cancers and some nonmalignant conditions. Over the years, the techniques and treatment methods have been better dened and continue to evolve from low-dose-rate (LDR) to high-doserate (HDR) to pulsed-dose-rate (PDR) methods. Use of radium has been abandoned in favor of safer radioactive sources. Some areas where implants are clinically used include the head/neck area, where there is a plethora of experience in organ preservation and quality-of-life issues; for lung cancers, implants are mainly used to palliate symptoms; for esophageal and skin cancers, implants oer a chance of a durable clinical response; for sarcomas, anal and rectal cancers, and uveal melanomas, there is emphasis on functional outcome. e use of brachytherapy to treat some nonmalignant conditions such as the pterygium and keloids is also discussed in the following chapter.