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Review
. 2024 Oct 9;16(19):3424.
doi: 10.3390/cancers16193424.

Personalized Brachytherapy: Applications and Future Directions

Piyush Pathak  1 , Justin J Thomas  1 , Arjit Baghwala  2 , Chengfeng Li  2 , Bin S Teh  2 , Edward B Butler  2 , Andrew M Farach  2
Affiliations
Review

Personalized Brachytherapy: Applications and Future Directions

Piyush Pathak et al. Cancers (Basel). .

Abstract

Brachytherapy offers a highly conformal and adaptive approach to radiation therapy for various oncologic conditions. This review explores the rationale, applications, technological advances, and future directions of personalized brachytherapy. Integration of advanced imaging techniques, 3D-printed applicators, and artificial intelligence are rapidly enhancing brachytherapy delivery and efficiency, while genomic tests and molecular biomarkers are refining patient and dose selection. Emerging research on combining brachytherapy with immunotherapy offers unique synergistic potential, and technologies such as intensity-modulated and shielded brachytherapy applicators present novel opportunities to further optimize dose distributions. Despite these promising advances, the field faces challenges including a need to train more practitioners and develop new approaches to treating a broader range of malignancies. As personalized medicine evolves, brachytherapy's ability to deliver highly targeted, individualized treatments positions it as a critical component in future cancer care.

Keywords: 3D-printed applicators; artificial intelligence in radiation oncology; brachytherapy–immunotherapy combination; genomic biomarkers; image-guided adaptive radiotherapy; intensity-modulated brachytherapy; personalized brachytherapy; precision oncology; shielded brachytherapy; treatment planning optimization.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
(A) Right thumb squamous cell carcinoma prior to radiation therapy. (B) Clinical setup utilizing custom surface mold applicators wrapped in elastic bandage.
Figure 2
Figure 2
(A) Transrectal ultrasound visualization of rectal tumor after needle insertion. (B) Kelowna gynecologic template with transperineal needles in place.
Figure 3
Figure 3
(A) Fluoroscopic appearance after transperineal needle insertion with radiopaque contrast in bladder. (B) Transperineal needles and template after completion of procedure.
Figure 4
Figure 4
(A) Close-up view of oral cavity and interstitial applicators, illustrating submental approach. (B) Overall view of patient positioning during procedure, including prophylactic tracheostomy.
See this image and copyright information in PMC

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