First clinical implementation of GammaTile permanent brain implants after FDA clearance

Clara Ferreira, David Sterling, Margaret Reynolds, Kathryn Dusenbery, Clark Chen, Parham Alaei

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

Purpose: GammaTile cesium-131 (131Cs) permanent brain implant has received Food and Drug Administration (FDA) clearance as a promising treatment for certain brain tumors. Our center was the first institution in the United States after FDA clearance to offer the clinical use of GammaTile brachytherapy outside of a clinical trial. The purpose of this work is to aid the medical physicist and radiation oncologist in implementing this collagen carrier tile brachytherapy (CTBT) program in their practice. Methods: A total of 23 patients have been treated with GammaTile to date at our center. Treatment planning system (TPS) commissioning was performed by configuring the parameters for the 131Cs (IsoRay Model CS-1, Rev2) source, and doses were validated with the consensus data from the American Association of Physicists in Medicine TG-43U1S2. Implant procedures, dosimetry, postimplant planning, and target delineations were established based on our clinical experience. Radiation safety aspects were evaluated based on exposure rate measurements of implanted patients, as well as body and ring badge measurements. Results: An estimated timeframe of the GammaTile clinical responsibilities for the medical physicist, radiation oncologist, and neurosurgeon is presented. TPS doses were validated with published dose to water for 131Cs. Clinical aspects, including estimation of the number of tiles, treatment planning, dosimetry, and radiation safety considerations, are presented. Conclusion: The implementation of the GammaTile program requires collaboration from multiple specialties, including medical physics, radiation oncology, and neurosurgery. This manuscript provides a roadmap for the implementation of this therapy.

Original languageEnglish (US)
Pages (from-to)673-685
Number of pages13
JournalBrachytherapy
Volume20
Issue number3
Early online dateJan 21 2021
DOIs
StatePublished - Jan 26 2021

Bibliographical note

Publisher Copyright:
© 2020 The Authors

Keywords

  • Brain cancer
  • Cesium-131
  • Collagen carrier tile brachytherapy (CTBT)
  • GammaTile

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