The Experts below are selected from a list of 21 Experts worldwide ranked by ideXlab platform
Bruce Tromberg - One of the best experts on this subject based on the ideXlab platform.
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An Indwelling Brachytherapy Balloon Catheter: Potential Use as an Intracranial Light Applicator for Photodynamic Therapy
Journal of Neuro-Oncology, 1999Co-Authors: Henry Hirschberg, Steen Madsen, Knut Lote, Tuan Pham, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface. Measurements of light distribution in a phantom model surrounding the Balloon Catheter, show that it may be used to deliver sufficiently uniform light doses during PDT. The light distribution is uniform to within 5% when the Balloon is filled with a scattering medium. Based on simple assumptions, it is shown that the applicator can be used to deliver a sufficient optical dose to brain tissue at a depth of 1 cm in less than 1 h. The applicator has already been used for Brachytherapy in 72 patients with few complications. A new treatment protocol employing the combination of both fractionated intracavity Brachytherapy and PDT is currently being planned.
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an indwelling Brachytherapy Balloon Catheter potential use as an intracranial light applicator for photodynamic therapy
Journal of Neuro-oncology, 1999Co-Authors: Henry Hirschberg, Knut Lote, Tuan Pham, Steen J Madsen, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface.
Henry Hirschberg - One of the best experts on this subject based on the ideXlab platform.
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An Indwelling Brachytherapy Balloon Catheter: Potential Use as an Intracranial Light Applicator for Photodynamic Therapy
Journal of Neuro-Oncology, 1999Co-Authors: Henry Hirschberg, Steen Madsen, Knut Lote, Tuan Pham, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface. Measurements of light distribution in a phantom model surrounding the Balloon Catheter, show that it may be used to deliver sufficiently uniform light doses during PDT. The light distribution is uniform to within 5% when the Balloon is filled with a scattering medium. Based on simple assumptions, it is shown that the applicator can be used to deliver a sufficient optical dose to brain tissue at a depth of 1 cm in less than 1 h. The applicator has already been used for Brachytherapy in 72 patients with few complications. A new treatment protocol employing the combination of both fractionated intracavity Brachytherapy and PDT is currently being planned.
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an indwelling Brachytherapy Balloon Catheter potential use as an intracranial light applicator for photodynamic therapy
Journal of Neuro-oncology, 1999Co-Authors: Henry Hirschberg, Knut Lote, Tuan Pham, Steen J Madsen, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface.
Tuan Pham - One of the best experts on this subject based on the ideXlab platform.
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An Indwelling Brachytherapy Balloon Catheter: Potential Use as an Intracranial Light Applicator for Photodynamic Therapy
Journal of Neuro-Oncology, 1999Co-Authors: Henry Hirschberg, Steen Madsen, Knut Lote, Tuan Pham, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface. Measurements of light distribution in a phantom model surrounding the Balloon Catheter, show that it may be used to deliver sufficiently uniform light doses during PDT. The light distribution is uniform to within 5% when the Balloon is filled with a scattering medium. Based on simple assumptions, it is shown that the applicator can be used to deliver a sufficient optical dose to brain tissue at a depth of 1 cm in less than 1 h. The applicator has already been used for Brachytherapy in 72 patients with few complications. A new treatment protocol employing the combination of both fractionated intracavity Brachytherapy and PDT is currently being planned.
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an indwelling Brachytherapy Balloon Catheter potential use as an intracranial light applicator for photodynamic therapy
Journal of Neuro-oncology, 1999Co-Authors: Henry Hirschberg, Knut Lote, Tuan Pham, Steen J Madsen, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface.
Knut Lote - One of the best experts on this subject based on the ideXlab platform.
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An Indwelling Brachytherapy Balloon Catheter: Potential Use as an Intracranial Light Applicator for Photodynamic Therapy
Journal of Neuro-Oncology, 1999Co-Authors: Henry Hirschberg, Steen Madsen, Knut Lote, Tuan Pham, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface. Measurements of light distribution in a phantom model surrounding the Balloon Catheter, show that it may be used to deliver sufficiently uniform light doses during PDT. The light distribution is uniform to within 5% when the Balloon is filled with a scattering medium. Based on simple assumptions, it is shown that the applicator can be used to deliver a sufficient optical dose to brain tissue at a depth of 1 cm in less than 1 h. The applicator has already been used for Brachytherapy in 72 patients with few complications. A new treatment protocol employing the combination of both fractionated intracavity Brachytherapy and PDT is currently being planned.
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an indwelling Brachytherapy Balloon Catheter potential use as an intracranial light applicator for photodynamic therapy
Journal of Neuro-oncology, 1999Co-Authors: Henry Hirschberg, Knut Lote, Tuan Pham, Steen J Madsen, Bruce TrombergAbstract:An indwelling Balloon applicator developed for postoperative intracavity afterloading Brachytherapy was evaluated for photodynamic therapy (PDT). Following tumor resection, the applicator is positioned in the center of the resultant cavity and the Balloon is inflated with a scattering solution. The liquid-filled Balloon stabilizes the resection cavity ensuring a constant and simple geometric shape during treatment. The Catheter is brought out through the skin and adjusted so that 1–2 cm projects above the scalp surface.
Coral A Quiet - One of the best experts on this subject based on the ideXlab platform.
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3 year follow up of the partial breast irradiation trial for dcis using the mammosite Brachytherapy Balloon Catheter
Cancer Research, 2009Co-Authors: O Streeter, Coral A Quiet, Frank A Vicini, Henry Mark Kuerer, Pamela Benitez, V Mehta, Robert R Kuske, Monica Prasad Hayes, Douglas W Arthur, Eric A StromAbstract:Purpose: To report the 3-year median follow-up of a prospective Phase II partial breast irradiation (PBI) trial utilizing the MammoSite® interstitial Balloon as the sole radiation therapy treatment after lumpectomy for ductal carcinoma in situ (DCIS).Materials and Methods: One hundred and thirty-three patients were enrolled from May 2003 through January 2006 to reach the 100-patient partial breast irradiation (PBI) target goal of 34 Gy in 10 fractions, 1 cm peripheral to the MammoSite® Balloon surface, b.i.d. with Iridium 192 HDR Brachytherapy. The eligibility criteria were age 45, unicentric pure DCIS, mammographic size ≤3cm, negative margin of ≥1 mm, gross pathology size ≤5 cm, clinically node negative, post-lumpectomy mammogram absent of residual microcalcificaion. A USC/VNPI score was then calculated based on age, tumor size, margin width, and nuclear grade [ref: Silverstein MJ, Am J Surg 2003;186(4):337-343]. Placement of the Balloon was performed at the time of lumpectomy or post-lumpectomy with a required minimum distance of the Balloon surface to skin (skin bridge) of 5 mm. Data was collected at enrollment, at implant, 3 and 6-months, then yearly for local control, cosmesis (Harvard Scale), toxicity, adverse events, disease-free survival, cause-specific survival, and contralateral breast failure. Local recurrence is defined as either invasive or non-invasive within the target volume. Ipsilateral elsewhere recurrence (IER) is defined as invasive or non-invasive outside of the target volume.Results: Of the 133 patients enrolled, thirty-three were not treated for the following reasons: less than 5 mm skin bridge (n=13), poor cavity conformance (n=10), positive margin (n=3), microinvasion (n=3), MD decision (n=2), patient request (1), and other (1). The nuclear grade distribution of the tumors were: NG1(17%), NG2(44%), and NG3(39%). The mean age was 60.8 years. The mean tumor size was 10.6 mm; mean closest surgical margin was 6.8 mm (R=0.1-40mm); post-lumpectomy placement in 72%; mean skin bridge distance was 13 mm with 89% ≥7mm. No patients have been lost to follow-up, and at a median 3-year follow-up, the cosmetic results have been rated as excellent/good in 94 and fair in 6 patients. There have been only four recurrences, all non-invasive with the following histological patterns listed in the table below. One was an IER.No serious adverse events were reported with an infection rate of 9% (7 breast infections; 2 cellulitis).Conclusion: This is the longest reported prospective Phase II study using a PBI technique for pure DCIS patients, and continues to demonstrate the efficacy of the MammoSite® Balloon for treating pure DCIS breast tumors, with no new recurrences since our last report at SABCS 2007. All the recurrences were noninvasive, and had at least one or more risk factors of a high USC/VNPI score, high nuclear tumor grade, or had a comedo necrosis pattern. There have been no recurrences in nuclear grade 1 or 2 patients in the absence of a comedo necrosis pattern. The cosmesis also continues to be excellent or good long-term in 96% patients. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 952.
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descriptions and outcomes of insertion techniques of a breast Brachytherapy Balloon Catheter in 1403 patients enrolled in the american society of breast surgeons mammosite breast Brachytherapy registry trial
American Journal of Surgery, 2005Co-Authors: Victor J Zannis, Coral A Quiet, Peter D Beitsch, Frank A Vicini, Angela Keleher, Delia M Garcia, Howard Snider, Mark A Gittleman, Henry Mark Kuerer, Eric WhitacreAbstract:Abstract Background The use of the MammoSite Brachytherapy Balloon Catheter is 1 option for the delivery of accelerated partial breast irradiation during breast cancer therapy. The device can be inserted into the breast using 3 different techniques. This report describes these methods of insertion and correlates the technique with outcome data collected in a multi-institutional registry trial. Methods In the registry trial, MammoSite Catheters were inserted either (1) at the time of lumpectomy into an open cavity, (2) after surgery with ultrasound guidance through a separate small lateral incision into a closed cavity, or (3) after surgery by entering directly through the lumpectomy wound (the scar entry technique). Device placement techniques in 1403 patients with early stage breast cancer treated at 87 institutions by 223 different investigators were documented in the registry. Data collected included number of cases of each technique, age of patient, tumor size, skin spacing, Catheter pull rates and reasons, infection, radiation recall, cosmesis, and recurrence. Results Catheter placement at the time of lumpectomy was performed in 619 patients (44%), after surgery with ultrasound guidance in 576 patients (41%), and the scar entry technique technique in 197 patients (14%). The type of technique was not associated with age of patient, tumor size, bra size, Catheter size, skin spacing, infection, radiation recall, cosmesis, or recurrence. There was a statistically significant increased incidence of premature Catheter removals for pathologically related reasons with the open-cavity technique compared with the 2 postoperative methods secondary to final histology reports disqualifying the patient after MammoSite placement. Conclusions These registry data show that the MammoSite Catheter can be inserted with any 1 of 3 different techniques. A postoperative placement, after the final pathology report is issued, decreases the incidence of premature removal of the Catheter because of disqualifying pathology.
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postoperative ultrasound guided percutaneous placement of a new breast Brachytherapy Balloon Catheter
American Journal of Surgery, 2003Co-Authors: Victor J Zannis, Lise C Walker, Belinda Barclaywhite, Coral A QuietAbstract:Abstract Background The optimal technique and timing for the implantation of a recently developed breast Brachytherapy Balloon Catheter (MammoSite; Proxima Therapeutics, Alpharetta, Georgia) have not been well defined. We hypothesized that placing this postoperatively, utilizing percutaneous ultrasound-guided placement, would be preferable. Methods Patients who met eligibility requirements for breast Brachytherapy were implanted with the MammoSite device utilizing percutaneous ultrasound-guided technique. Additionally, to study optimal timing, a historical cohort of patients operated upon for breast cancer by two of the authors were analyzed to compare the intraoperative and postoperative candidacy for MammoSite placement. Results Twenty-one of 23 patients successfully completed Brachytherapy after implantation, with only 2 (9%) requiring Catheter removal secondary to unfavorable Balloon positioning. There were no serious complications. Of 343 historical patients with breast cancer, 137 were intraoperative candidates for Brachytherapy, but final postoperative histology disqualified 40 (29%). Conclusions Implantation of the MammoSite Brachytherapy device is optimally performed postoperatively, after the final pathology is defined, utilizing ultrasound-guided percutaneous technique.
