ISSN 2398-2977      

Strontium plesiotherapy

pequis

Introduction

  • Plesiotherapy is a form of radiotherapy Radiotherapy where the radiation source is applied directly to the tumor. This involves the use of a high activity, sealed source that can be applied to a pre-defined area whilst observing appropriate health and safety precautions. The most commonly described plesiotherapy source in veterinary medicine is a strontium-90 probe.
  • Strontium-90 has the advantage of a very long half-life of 28.7 years.
  • The β radiation produced by the strontium-90 itself is too weak to be of practical use. However, strontium-90 decays to yttrium-90, which produces β radiation at 2.27 MeV as it decays. This has a shallow depth of penetration, meaning that very high doses of radiation can be given to the surface of the tumor without risking exposure of any normal underlying or surrounding tissues.
  • The disadvantage of this treatment is that only superficial lesions or scars following incompletely excised tumors can be successfully treated.

Uses

  • Ionizing radiation of superficial tumors and tumor beds.
  • Adjunctive treatment following other therapies such as surgical excision.

Advantages

  • Beta source has limited penetration, so operator exposure risk is minimal.
  • Very effective for carefully selected lesions.
  • Slow effects, so easy to prevent excessive regional cytotoxic effects.
  • Localized treatment so suitable for use on delicate areas and with sensitive underlying structures (such as on the cornea).
  • Good cosmetic effects.
  • Most effective in tumors with rapidly dividing cells.
  • Good long-term success for squamous cell carcinomas Skin: neoplasia - squamous cell carcinoma, superficial sarcoids Sarcoid, and selected other lesions.

Disadvantages

  • Small risk of operator exposure (occupational hazard).
  • Limited availability.
  • Logistics.
  • Non-discriminatory (normal cells are also affected) so can have effects on rapidly dividing cells.
  • Administration requires personal protective equipment, radiation exposure monitoring, and documentation according to the health and safety policies of the country where the source is in use.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Excellent with appropriate case selection and treatment protocols.

Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Hollis A R (2019) Strontium plesiotherapy for the treatment of sarcoids in the horse. Equine Vet Educ WileyOnline.
  • Hollis A R (2017) Strontium-90 plesiotherapy in the horse. Equine Vet Educ 31 (3), 134-136 WileyOnline.
  • Hollis A R (2017) Radiotherapy for the treatment of periocular tumours in the horse. Equine Vet Educ 31 (12), 647-652 WileyOnline.
  • Pezzanite et al (2017) Aryepiglottic lymphoma in a 19-year-old Paint gelding treated with excision and adjunctive radiotherapy. Equine Vet Educ 31 (3), 130-133 VetMedResource.
  • Plummer C E et al (2007) Combined keratectomy, strontium-90 irradiation and permanent bulbar conjunctival grafts for corneolimbal squamous cell carcinomas in horses (1990-2002): 38 horses. Vet Ophthalmol 10 (1), 37-42 PubMed.

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