Introduction: Why and When Radiotherapy with iBT? When SBRT?

Abstract

Radiotherapy of the liver, lung, and other inner organs can be performed percutaneously and noninvasively by using modern stereotactic body radiotherapy (SBRT) strategies. The efficacy of these noninvasive approaches has been demonstrated in numerous tumor locations. Another option for applying high single doses is interstitial brachytherapy (iBT). Here, a radioactive source, for example, iridium-192, is inserted directly into the tumor through a catheter. iBT allows the delivery of very high doses of radiation in a single fraction, and, owing to the steep dose gradient, organs at risk can be efficiently spared. The available evidence suggests that this minimally invasive treatment is particularly advantageous in the treatment of large tumors (although substantial superiority of iBT compared with SBRT regarding the sparing of the surrounding tissue seems to decline with increasing lesion size) and owing to its repeatability.