Provincial cancer hospital has become the first in the UK – and one of the first in Europe – to deliver two high dose rate (HDR) brachytherapy radiotherapy treatments in the same day. The procedure at Bristol Oncology Centre using Varian’s GammaMed HDR afterloader and BrachyVision planning software often avoids the need for an uncomfortable overnight hospital stay for patients. HDR brachytherapy involves using needles or catheters to place a radiation source directly within the tumor. These needles are positioned within the tumor using images, treatment planning software, and a computer-controlled device called an afterloader. To maximize accuracy, the needles generally remain in position until all treatment sessions are completed. Dr Amit Bahl, senior oncologist at Bristol Oncology Centre, said, “When we first introduced brachytherapy treatments we used the standard procedure of delivering the first treatment on the first day and the second treatment a day later. This meant the patient would have to spend the night in hospital with the needles in place. By doing it on a single day, it is beneficial for patient comfort, it enables us to treat more patients and it is helping the NHS by freeing up bed space. “As well as making it much more comfortable for the patient, there is less chance for needle motion and it reduces the potential for the prostate becoming swollen, as tends to happen 24 hours after the needles have been inserted.” Dr Bahl said this innovative process has only been made possible thanks to the agreement and dedication of the entire clinical team. “It requires a lot of commitment from the entire team of oncologists, physicists, dosimetrists and radiotherapy nurses,” he says. “We are lucky here at Bristol because all our people strongly believe in this approach. “It works like clockwork and the team feels very happy. It is extremely fulfilling to complete the treatment by the end of the day, take the needles out and ensure that the patient has a much better night’s sleep. If the patient lives nearby, he can go home that same day.” HDR brachytherapy patients require at least six hours between treatment sessions to enable the body to recover. The team at Bristol treat two patients every other Monday using this process. Patients are normally suffering from locally advanced prostate cancer and they receive brachytherapy as a boost prior to receiving a full course of external beam radiotherapy. The device is used in combination with BrachyVision treatment planning software, which enables clinicians to plan treatments by combining and using MRI, CT and 3-D scans for the best possible images of the tumor and surrounding organs.