Treating cancer using intensity-modulated brachytherapy

1 . A system for treating cervical and/or uterine cancers in intensity modulated brachytherapy with an intracavitary brachytherapy applicator, comprising:

a tandem assembly comprising a tandem and a tandem connector, the tandem configured for insertion into a cervix of a patient and the tandem connector configured to receive the tandem within an interior of the tandem connector along a longitudinal axis, the tandem connector comprising one or more grooves arranged along the longitudinal axis, the tandem comprising a multi-lumen shaft configured to receive one or more wires therethrough, each of the one or more wires comprising a metal having an atomic number greater than 70;

an ovoid assembly comprising first and second adjustably inflatable ovoids and an ovoid support mechanism, the ovoid assembly comprising first and second handles configured to support the respective first and second inflatable ovoids, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids using a unidirectional adjustment mechanism, each of the handles comprising a multi-lumen shaft, the handles configured to allow for user manipulation to control the relative position of the ovoids for insertion of the ovoids within the fornices of the patient, the first and second adjustably inflatable ovoids having a deflated configuration for insertion into the patient and one or more adjustably inflated configurations for positioning the ovoid assembly during treatment, the ovoid support mechanism configured to establish a longitudinal position of the ovoid assembly relative to the tandem based on a coupling of the ovoid support mechanism with the one or more grooves of the tandem connector; and

a first inflatable retractor configured to be releasably coupled to the ovoid assembly, the first inflatable retractor having a deflated configuration for insertion into the patient and an adjustably inflated configuration for retraction of tissue during treatment;

wherein the tandem and the first and second inflatable ovoids are configured to be coupled to a radioactive source to deliver an implant radiation dose suitable for cancer treatment at a cancerous cervical and/or uterus treatment site in the patient; and

wherein a first lumen of the multi-lumen shaft of the tandem is configured to receive a first radiation source positioned within the first lumen during treatment, and wherein a second lumen of the multi-lumen shaft of the tandem is configured to receive a first wire of the one or more wires comprising a metal having an atomic number greater than 70 positioned within the second lumen during treatment with substantially synchronous movement relative to the first radiation source to provide radiation shielding in a direction of tissue not intended for radiation treatment.

2 . The system of claim 1 , wherein the metal comprises at least one of gold or tungsten.

3 . The system of claim 1 , further comprising an optical fiber, wherein the optical fiber is configured for coupling to a camera to facilitate positioning of the tandem.

4 . The system of claim 1 , wherein the multi-lumen shaft of the tandem comprises at least three lumens.

5 . The system of claim 1 , wherein the multi-lumen shaft of the tandem is configured to link an optical fiber therethrough.

6 . A system for treating cervical and/or uterine cancers, the system comprising:

a tandem assembly comprising a tandem and a tandem connector, the tandem configured for insertion into a cervix of a patient and the tandem connector configured to receive the tandem within an interior of the tandem connector along a longitudinal axis;

an ovoid assembly comprising first and second adjustably inflatable ovoids and an ovoid support mechanism, wherein the ovoid assembly comprises first and second handles configured to support the respective first and second inflatable ovoids, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids for insertion of the ovoids within the fornices of the patient, the first and second adjustably inflatable ovoids having a deflated configuration for insertion into the patient and one or more adjustably inflated configurations for positioning the ovoid assembly during treatment;

first and second adjustably inflatable retractors configured to be releasably coupled to the ovoid assembly, the first and second inflatable retractors having a deflated configuration for insertion into the patient and an adjustably inflated configuration for retraction of tissue during treatment; and

at least one wire comprising a metal having an atomic number of greater than 70, the wire configured to reduce an amount of radiation passing therethrough;

wherein the ovoid support mechanism is configured to establish a position of the ovoid assembly relative to the tandem based on a coupling of the ovoid support mechanism with the tandem assembly, wherein the tandem and the first and second inflatable ovoids are configured to be coupled to a radioactive source to deliver an implant radiation dose suitable for cancer treatment at a cancerous cervical and/or uterus treatment site in the patient, wherein at least one of the tandem and the first and second inflatable ovoids is configured as a multi-lumen component; and

wherein each multi-lumen component has a radiation lumen configured to receive a radiation source positioned therein during treatment, and wherein each multi-lumen component also has a shielding lumen configured to receive a wire of the at least one wire comprising a metal having an atomic number of greater than 70 positioned therein during treatment with substantially synchronous movement relative to the radiation source to provide radiation shielding in a direction of tissue not intended for radiation treatment.

7 . The system of claim 6 , wherein, the tandem comprises a multi-lumen shaft with at least three lumens configured to deliver shielded radiation therapy therethrough.

8 . The system of claim 7 , further comprising an optical fiber, wherein the optical fiber is configured for coupling to a camera to facilitate positioning of the tandem.

9 . The system of claim 7 , wherein the multi-lumen shaft of the tandem comprises at least three lumens.

10 . The system of claim 7 , wherein the ovoid assembly comprises a unidirectional adjustment mechanism configured to allow modification of an angular position of the first and second inflatable ovoids relative to the tandem assembly.

11 . The system of claim 6 , wherein each of the handles comprises a multi-lumen shaft with at least three lumens, respectively, configured to deliver shielded radiation therapy therethrough.

12 . A method for providing intensity-modulated thermoradiotherapy, the method comprising:

providing a system comprising:

a tandem assembly comprising a tandem and a tandem connector, the tandem configured for insertion into a cervix of a patient and the tandem connector configured to receive the tandem within an interior of the tandem connector along a longitudinal axis;

an ovoid assembly comprising first and second adjustably inflatable ovoids and an ovoid support mechanism, wherein the ovoid assembly comprises first and second handles configured to support the respective first and second inflatable ovoids, wherein the handles are configured to allow for user manipulation to control a relative position of the ovoids, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids for insertion of the ovoids within the fornices of the patient, the first and second adjustably inflatable ovoids having a deflated configuration for insertion into the patient and one or more adjustably inflated configurations for positioning the ovoid assembly during treatment;

first and second adjustably inflatable retractors configured to be releasably coupled to the ovoid assembly, the first and second inflatable retractors having a deflated configuration for insertion into the patient and an adjustably inflated configuration for retraction of tissue during the treatment; and

at least one wire comprising a metal having an atomic number of greater than 70, the wire configured to reduce an amount of radiation passing therethrough;

wherein the ovoid support mechanism is configured to establish a position of the ovoid assembly relative to the tandem based on a coupling of the ovoid support mechanism with the tandem assembly, wherein the tandem and the first and second inflatable ovoids are configured to be coupled to a radioactive source to deliver an implant radiation dose suitable for cancer treatment at a cancerous cervical and/or uterus treatment site in the patient, wherein at least one of the tandem and the first and second inflatable ovoids is configured as a multi-lumen component; and

wherein each multi-lumen component has a radiation lumen configured to receive a radiation source positioned therein during the treatment, and wherein each multi-lumen component also has a shielding lumen configured to receive a wire of the at least one wire comprising the metal having an atomic number of greater than 70 positioned therein during the treatment with substantially synchronous movement relative to the radiation source to provide radiation shielding in a direction of tissue not intended for radiation treatment;

inserting the tandem into the cervix of a patient

inflating the ovoid assembly comprising the first and second adjustably inflatable ovoids with fluid;

manipulating the handles of the ovoid assembly to control the relative position of the ovoids within the fornices of the patient;

inflating the first and second adjustably inflatable retractors coupled to the tandem with fluid; and

delivering the implant radiation dose suitable for the cancer treatment at the cancerous cervical treatment site in the patient, wherein each radiation lumen receives a respective radiation source positioned within each respective radiation lumen, and wherein each shielding lumen receives a respective wire of the at least one wire comprising the metal having an atomic number of greater than 70 positioned within each respective shielding lumen with the substantially synchronous movement relative to the respective radiation source to provide the radiation shielding in the direction of the tissue not intended for the radiation treatment.

13 . The method of claim 12 , wherein the metal comprises at least one of gold or tungsten.

14 . A system for treating cervical and/or uterine cancers, the system comprising:

a tandem configured for insertion into a cervix of a patient;

an ovoid assembly configured to be coupled to the tandem via at least one groove on the tandem, the ovoid assembly comprising first and second inflatable ovoids and an ovoid support mechanism, wherein the ovoid assembly comprises first and second handles configured to support the respective first and second inflatable ovoids, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids with respect to each other, wherein the handles are configured to allow for user manipulation to control the relative position of the ovoids for insertion of the ovoids within the fornices of the patient, the first and second inflatable ovoids having a deflated configuration for insertion into the patient and one or more inflated configurations for positioning the ovoid assembly during treatment;

wherein the ovoid support mechanism is configured to establish a position of the ovoid assembly relative to the tandem based on a coupling of the ovoid support mechanism with the tandem assembly, wherein the tandem and the first and second inflatable ovoids are configured to be coupled to a radioactive source to deliver an implant radiation dose suitable for cancer treatment at a cancerous cervical and/or uterus treatment site in the patient, wherein at least one of the tandem and the first and second inflatable ovoids is configured as a multi-lumen component; and

wherein each multi-lumen component has a radiation lumen configured to receive a radiation source positioned therein during treatment, and wherein each multi-lumen component also has a shielding lumen configured to receive a wire comprising a metal having an atomic number greater than 70 positioned therein during treatment with substantially synchronous movement relative to the radiation source to provide radiation shielding in a direction of tissue not intended for radiation treatment.

15 . The system of claim 14 , further comprising an optical fiber, wherein the optical fiber is configured for coupling to a camera to facilitate positioning of the tandem.

16 . The system of claim 14 , further comprising one or more wires comprising one or more metals having an atomic number of greater than 70, the one or more wires configured to reduce an amount of radiation passing therethrough.

17 . The system of claim 14 , wherein the metal comprises at least one of gold or tungsten.

18 . The system of claim 14 , wherein the tandem comprises a multi-lumen configuration.

19 . The system of claim 14 , wherein at least one of the ovoids comprises a multi-lumen configuration.

20 . The system of claim 14 , wherein the tandem comprises a multi-lumen configuration with at least one lumen configured to link to an optical fiber positioned therethrough.

21 . The system of claim 14 , comprising first and second inflatable retractors configured to be releasably coupled to the ovoid assembly, the first and second inflatable retractors having a deflated configuration for insertion into the patient and an inflated configuration for retraction of tissue during treatment.