ABSTRACT
BACKGROUND
Locoregional failure is a unique and challenging problem in head and neck cancer with
controversy surrounding the use of re-irradiation in the treatment. We aimed to evaluate
the dosimetry and technical parameters in utilizing a collagen matrix with embedded
Cesium-131 (Cs-131) radioactive isotope seeds as it relates to dose distribution and
dose to carotid artery.
METHODS AND MATERIALS
Cadaveric feasibility study randomizing Cs-131 strands alone or Cs-131 with collagen
matrix to be placed into neck dissection defects. For the dose computation, physicists
employed the TG-43 dosimetry calculation algorithm with a point source assumption
to compute the dose. Carotid arteries were contoured in MIM-Symphony software and
the carotid artery maximum and mean doses were calculated in accordance with TG-43
specifications. Ease of use of collagen matrix tiles on a 7-point Likert scale and
mean radiation dose to the carotid artery.
RESULTS
Ease of use score was higher in collagen matrix compared to stranded seeds with a
mean score of 6.3 +/- 1.2 compared to 4.5 +/- 0.87. Time of implantation was statistically
significantly, p = 0.031, lower in the collagen matrix group (M = 5.17 min, SD = 4.62) compared to
stranded seeds (M = 15.83 min, SD = 3.24). Mean radiation dose to the carotid artery
was 62.8 Gy +/- 9.46 in the collagen matrix group compared to 108.2 Gy +/- 55.6 in
the traditional Cs-131 seeds group.
CONCLUSIONS
We present a feasibility and concept cadaveric study using a collagen matrix with
Cesium-131 demonstrating preliminary evidence to support its ease of use, decreased
time to implantation, and decreased dose delivered to the carotid artery.
Keywords
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Article info
Publication history
Published online: November 08, 2022
Accepted:
September 28,
2022
Received:
June 12,
2022
Footnotes
Disclosures: None
Identification
Copyright
© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
