Thermobrachytherapy: Requirements for the Future

Brachytherapy provides an obvious and sometimes ideal setting for combining hyperthermia with radiation therapy. Such combination therapy has been done in the past primarily using microwave technology where multiple antennae are placed intra- tumorally into plastic catheters previously inserted for this purpose (e.g., Perez and Emami 1985; Couglin and Strohbehn 1989). There are a number of situations, particularly in the head and neck region, where this methodology is useful but does not lend itself easily to automation and does not adapt well to the simultaneous application of afterloaders. Another situation where hyperthermia can and has been applied (e.g., Aristizabal and Oleson 1984; Kong et al. 1986; Vora et al. 1987) is for implants that involve stainless steel needles to contain the radioactive materials which are usually done in conjunction with a cutaneously attached template guidance apparatus (e.g., Martinez et al. 1984). Other approaches include needles heated with electrical heating elements (Garcia et al. 1992)