Lyndal Newmarch
Royal Adelaide Hospital
Senior Radiation Therapist

PURPOSE To give an overview of three patients treated by high dose rate brachytherapy using individualised custom-made surface moulds with 3D CT planning. METHODS AND MATERIALS Three patients with custom made surface moulds were selected to highlight the diversity in treatment techniques utilised when treating surface tumours with HDR brachytherapy at the RAH. These patients were selected to show the different methods and materials used in making the surface moulds. The first patient with recurrent SCC of the tip of nose was treated using a custom made thermoplastic applicator shaped over a plaster mould of the patients face, 39.6Gy, 4.4Gy/#, 9#s, computer planned. The second patient with recurrent SCC of the skin of the scalp was treated using a custom made wax applicator shaped over a plaster mould of the patients scalp and neck, 51.0Gy, 2.55Gy/#, 20#s, computer planned. Finally the third patient with Myxofibrosarcoma of the left anterior thigh was treated using a custom made superflab shaped over the patient’s leg, 38.5Gy, 3.85Gy/#, 10# computer planned. RESULTS Many different commercial surface moulds and applicators exist for use with a HDR Brachytherapy unit. At the RAH with custom made surface moulds utilising different techniques, materials and methods of preparation we are able provide excellent dosimetric results by tailoring the surface mould to the individual patients requirements. Thermoplastic moulds, wax moulds and superflab applicators are three techniques used at the RAH. CONCLUSIONS HDR Brachytherapy is a highly effective treatment option for treating surface and subcutaneous carcinomas. Custom made moulds make it possible to deliver a uniform dose distribution with HDR Brachytherapy, they are easy and safe to use and highly accurate for daily treatment replication.


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