Elekta publ : Patient in Germany is world’s first to receive brachytherapy with Elekta’s new Venezia gynecological applicator

Applicator maximizes anatomical reach of therapeutic radiation for patients with advanced cervical cancer

A 51-year-old patient with advanced cervical cancer became the world's first to receive brachytherapy assisted by Elekta's Venezia™, a gynecological applicator designed to reach not only the cervix, but also disease that has spread to the parametrium and vagina. Cervical cancer is the third-most common cancer among women worldwide, with an annual incidence of 530,000 cases and 250,000 deaths. In the developing world, it is the leading cause of cancer death among women.

Using Venezia™, physicians at Ludwig-Maximilians University of Munich (LMU Munich) successfully performed the interstitial brachytherapy procedure. Venezia allows clinicians to treat advanced stages of cervical cancer, such as stages IIIA and IIIB with vaginal and parametrial extensions, which previously required very specialized techniques, such as freehand needle placement.

'Getting the radiation to reach to disease extensions beyond the cervix has always been challenging with conventional brachytherapy applicators,' says Stefanie Corradini, MD, radiation oncologist at LMU Munich. 'Venezia incorporates components that enable us to treat the cervix as well as the parametrium and vagina using a single applicator. We were able to treat this first patient's disease extension in these anatomies by placing both parallel and oblique interstitial needles. With Venezia, we will have a very standardized way to treat cervical cancer and interstitial needle placement will be very reproducible.'

'The design of Venezia makes it intuitive to use,' adds LMU Munich's Cornelius Maihöfer, MD. 'Within just a few trial runs of applicator assembly, the team became proficient in handling Venezia.'

The two lunar-shaped ovoids of Venezia form a ring that when clicked together provide the ease of insertion of a tandem and ovoid applicator in combination with the dose distribution provided by a ring applicator. The ring creates a pear-shaped dose distribution, a proven dosimetry shape that matches the cervix and endometrium. To reach tumor extension beyond the cervix, the design also incorporates a perineal template for placement of parallel needles and holes in the ring for insertion of oblique needles.

'You could view Venezia as a hybrid brachytherapy applicator that combines the best characteristics of both ring and ovoid devices as well as an array of interstitial catheters that can be customized to each patient´s tumor anatomy,' Dr. Corradini says.

To learn more, visit www.elekta.com/Venezia.

1. Banerjee R, Kamrava M. Brachytherapy in the treatment of cervical cancer: a review. Int J Womens Health. 2014; 6: 555-564. Published online 2014 May 28. doi: 10.2147/IJWH.S46247.

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