High dose rate brachytherapy is the most advanced form of controlling brachytherapy delivery.
Brachytherapy (which literally means "close" or "short therapy" because of where the radiation is placed) is a method of placing a radiation source or sources directly into the location of the cancer. It can be placed through needles, tubes or catheters, or by "applicators" into body cavities such as the vagina or esophagus. The brachytherapy physician determines which method is most suitable to treat a particular tumor. Brachytherapy can be delivered with Low Dose Rate, which means the radiation is given more slowly (typically continuously over a two to three day period, or even over several months), or with High Dose Rate, which means a high dose is given in a short time - it typically takes only a matter of minutes to actually deliver the radiation. (Although it may take one to several hours to plan how to best deliver the High Dose Rate radiation.)

Our practice has been safely performing HDR Brachytherapy for over 20 years and LDR Brachytherapy for even longer. Dr.Bermudez-Webb (now retired) was instrumental in bringing HDR into practice in the early 1980's. Central Indiana Cancer Center now has a mobile HDR unit , allowing it to be moved to different treatment centers to treat patients in more than one location. This was the first mobile HDR unit in this NRC (Nuclear Regulatory Commission) region.

High Dose Rate brachytherapy is usually delivered by a "remote afterloader". This system consists of an extremely high intensity radiation seed, attached to a cable. A computerized stepping motor moves the cable, so that the seed's location can be precisely controlled.This all resides within the HDR unit. The unit is controlled by a specialized computer. This computer tells the stepping motor in the HDR unit where to place the radiation source, so that the HDR unit moves the radiation seed into precise locations within the attached needle or catheter or applicator. It also controls precisely how long the source stays at each location. By moving the radiation source to many different precise locations in the treatment device, and by controlling how long the source stays at each one of these different locations, the result is a perfectly shaped delivery of radiation around the treatment device. Because the radiation does not have to be "beamed in" through normal organs, huge doses of radiation can be safely given in one setting. In order to give this precise radiation delivery, the Radiation Oncologist (the brachytherapy physician) works closely with a radiation physicist and a 3 Dimensional computer planning system -- using CT images -- to determine the best way to deliver the HDR radiation within the treatment device. Multiple different plans can be reviewed prior to determining the best one to use, and each plan is custom - adjusted by the radiation oncologist prior using it to treat the patient.

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Central Indiana Cancer Centers has a highly experienced brachyfherapy team, consisting of physicians (radiation oncologists), physics staff, brachyfherapy nurses, and therapists who provide brachytherapy treatments on a regular basis. Ours is one of the most active HDR programs in the Midwest.
Just from 2002 through 2005 alone, our brachytherapy team performed 1170 procedures.
This wealth of experience is invaluable in making sure that every patient receives the best possible brachytherapy treatment while being kept comfortable and safe. Central Indiana Cancer Centers has the only mobile HDR unit in the state, allowing patients at all of our treatment centers to have access to this advanced form of treatment.

• Cervix HDR
• Chest Wall HDR (used to treat lung or other cancers that have invaded the ribs)
• Coronary artery HDR (used for blockage of cardiac stents)
• Esophagus HDR
• GliaSite (an implanted balloon used to treat brain tumors)
• 1-131 (used to treat thyroid cancer)
• Lung HDR (treating tumors inside the bronchus, or “airway”)
• MammoSite HDR (an implanted balloon used to treat breast cancer)
• Nasopharynx HDR
• Prostate - Prostate HDR or LDR seeds
• Quadramet (Sm-153, used to treat multiple bone metastases in one injection)
• Rectal cancer recurrence
• Soft tissue HDR - such as sarcomas
• Tongue and floor of mouth HDR
• Uterus HDR
• Vagina HDR
• Zevalin (an injection used to treat lymphomas)