Safe and Curative Brachytherapy Reirradiation with Organ-Sparing Hyaluronate Gel Injection

In radiotherapy, sufficient dose delivery promises local cure [Hayashi, 2002; Okamoto, 2002; Wu, 2007] and reirradiation is as effective as the first radiotherapy. Dose dependency of the effect is also reported in reirradiation [Damast, 2010]. In the clinical situation, however, the use of reirradiation is limited because of the low tolerance level of surrounding normal tissue [Emami, 1991]. A significant incidence of late toxicity attributable to accumulated dose in various at-risk organs is reported [Salama, 2006; Wu, 2007]. In a survey of the attitudes of radiation oncologists, only one third (90 of 271) of participants responded that they would consider reirradiation for in-field failure after previous radical radiotherapy [Joseph, 2008].