We present a case study of the treatment of localized squamous cell carcinoma on the glans penis with a custom-fabricated high-dose-rate (HDR) brachytherapy applicator.
A cylindrically shaped applicator was fabricated with eight embedded channels suitable for standard plastic brachytherapy catheters. An additional custom silicone bolus/sleeve was designed to be used with the 3D-printed applicator to provide an additional offset from the source to skin to reduce the surface dose and for patient comfort.
The patient (recurrent cT1a penile cancer) underwent CT simulation, and the brachytherapy plan was created with a nominal prescription dose of 40 Gy in 10 fractions given bidaily to the surface, and 35 Gy at 5 mm depth. Dose coverage to the clinical target volume was 94% (D90). Most fractions were treated with only 5-10 min of setup time. Follow up visits up to 1 year showed no evidence of disease with no significant changes in urinary and sexual function and limited cosmetic detriment to the patient.
Patient-specific organ-sparing HDR plesiotherapy using 3D printing technology can provide reliable and reproducible patient setup and may be effective in achieving disease control for superficial penile cancer, although preserving patient quality of life.
Brachytherapy. 2023 Jul 19 [Epub ahead of print]
Hugh H C Lee, Tsuicheng D Chiu, Brian Hrycushko, Zhenyu Xiong, Steve Hudak, Solomon Woldu, Ryan Mauck, Terry Corwin, Xiaosong Meng, Vitaly Margulis, Neil Desai, Michael R Folkert, Aurelie Garant
Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX., Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: ., Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX.