Letter from the Editor-in-Chief

Dear Colleagues,

It is my pleasure to announce this year the fifth issue of our Journal. Already, ESTRO 38 Meeting in Milan and ABS Annual Meeting in Miami have passed, but it’s not a pity as next year we’ll have an opportunity to meet again at the World Congress of Brachytherapy in Vienna, Austria (April 2-4, 2020).
Already for the fifth time the Greater Poland Cancer Center along with the Polish Brachytherapy Society organized “Interventional radiotherapy – Post ABS Meeting” which was held on September 6-7, 2019 for all those Polish brachytherapy providers that were not able to attend the American meeting. We used this opportunity and organized the General Assembly of our Society combined with necessary elections for Presidents and Board Members. I am proud to announce the voting results:

Polish Brachytherapy Society (PBS) General Assembly along with Elections

President:
Piotr Wojcieszek, MD, PhD
(Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice)

Vice-Presidents:
Ewa Burchardt, MD, PhD (Greater Poland Cancer Center, Poznań)
Tomasz Filipowski, MD, PhD (Białystok Cancer Center, Białystok)

Board:
Magdalena Stankiewicz, MD – Secretary
(Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice)
Tomasz Krzysztofiak, MD – Treasurer
(Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice)
Anna Kulik, MD, PhD
(Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw)
Marcin Hetnał, MD, PhD
(Amethyst Radiotherapy Center, Cracow)

Please find a separate Editorial Note from our brand-new PBS President Piotr Wojcieszek who would like to address a few words to the noble international brachytherapy community. Personally, I congratulate him on his new challenging role in his professional life and wish him all the best in achieving everyday successes. I also assure Piotr and all PBS Board Members about my support and devotion in terms of brachytherapy strengthening via PBS and JCB.
Just a week earlier members of our friendly Indian Brachytherapy Society (IBS) had their 9th Annual Conference of IBS (IBSCON 2019), which was titled “Precision Brachytherapy – The Art and Science” and its proceedings summary can be found at the end of this issue. It is worth noting that the conference keynote lecture was delivered by Dr. Christine Haie-Meder, widely-known brachytherapy pioneer of Gustave Roussy Institute, Paris. Her speech on “Clinical relevance of brachytherapy in the global oncological landscape” was received with appreciation and applause.
The issue 5/2019 starts with a clinical investigation by Justin Barnes et al. (USA) on single fraction brachytherapy in management of low and intermediate risk prostate cancer. Their early results from a single institution suggest that single fraction HDR-BT with 19 Gy has limited toxicity, however they noticed suboptimal biochemical control in 3 out of 28 patients.
Yasushi Nakai et al. from Japan conducted a randomized controlled study on the substantiation of combined prostate cancer LDR BT treatment with α-1 adrenoceptor antagonist alone or in combination with cyclooxygenase-2 inhibitor in terms of patient’s quality of life (QOL). They concluded that such combination does not warrant improvement of patient’s QOL.
Another three papers focus on cervical cancer. The first one comes from Portugal and is another proof in the literature of the need of implementing brachytherapy in the radical treatment of cervical cancer. Brachytherapy boost is associated with a lower recurrence rate and better overall survival and recurrence-free survival in comparison with EBRT boost, which additionally may be related to a three-fold increase in the risk of recurrence. The second one submitted by our Indian colleagues is an interinstitutional comparison of the cervical cancer treatment results and two different brachytherapy boost fractionation schedules – the details to be read in the article. The third cervical paper comes also from India and its authors claim that boosts with less HDR BT fractions are clinically equivocal and have some more advantages over boosts with more fractions with lower doses – to be thought over and compared with your own practice.
Not every patient is easy to manage depending on his/her clinical stage. But even in very difficult situations, brachytherapy may have something to say. For Constanze Heinze et al. from Germany, oligometastatic lymph node metastases of the retroperitoneal space are not a big problem to solve. One can manage selected patients with CT-guided HDR interstitial BT safely and ablate their disease even there.
Eyelid carcinoma is also a rare and difficult problem for clinicians and their patients. Andrea Vavassori et al. (Italy) present their mold-based surface HDR BT technique and stress that it’s safe, effective and offers very good local control.
Now I have a little surprise. Next two case reports should be of interest as they coincide here by accident. Both focus on the abscopal effect initiated by administration of interstitial brachytherapy. The first report by Salvatore Roberto Bellia et al. from Italy presents clinical evidence of the abscopal effect in cutaneous squamous cell carcinoma treated with Diffusing Alpha-emitters Radiation Therapy (DaRT), an emerging technique presented on the cover. The other one by Gen Suzuki et al. (Japan) shows the abscopal effect of HDR BT on pelvic bone metastases from renal cell carcinoma. As the author concludes, immuno-oncology effects are not limited to external beam irradiation regimens as they can also be attained by brachytherapy.
There are also two physics contributions from Poland and Iran. The former is on HDR endobronchial brachytherapy based on three-dimensional imaging and treatment planning, which results in better target coverage and may improve survival. The latter is an evaluation of a deformable image registration algorithm for determination of the accumulated dose for brachytherapy of cervical cancer patients.
The last paper is a pictorial essay from China with plenty of photos of an individualized cylindrical vaginal applicator with oblique guide holes manufactured using 3D modeling and printing technologies.
For those tired of reading my Editorial and this issue I have a special and extremely unique offer. A few weeks ago a Polish writer Olga Tokarczuk won the Nobel Prize in Literature for 2018. It’s my great pleasure to recommend to you one of her masterpieces “Flights” perfectly translated to English by Jennifer Croft. Have a nice reading rich in reflections as I had once…

Yours sincerely,

Adam Chicheł, MD, PhD
Editor-in-Chief

Journal of Contemporary Brachytherapy