title: Brachytherapy catheter spacing and stabilization technique.
abstract: OBJECTIVE
  To facilitate catheter spacing, implant stability, and patient comfort during multicatheter interstitial brachytherapy.
  
  
  METHODS
  Uniform and consistent spacing of multiple interstitial implant catheters can be difficult because individual catheters may become displaced during the course of treatment. The authors have developed a brachytherapy catheter fixation method using Jackson-Pratt (JP) drains that can be used within wounds to maintain catheter spacing or on the skin surface for applicator fixation. JP drains are threaded over the implant needles to space and stabilize the implant geometry. The needles are then replaced with the usual brachytherapy catheters.
  
  
  RESULTS
  Surgically directed ("open") placement of implant catheters is less prone to displacement when a drain connects and spaces the catheters in the wound. Fixation on the skin surface can also be achieved with the JP drains, which make the friction buttons optional. The soft drain material helps avoid discomfort and pressure injury sometimes associated with hard plastic buttons. Small (10 French) round JP drains are suitable for breast, and head and neck sites and larger 7×10-mm flat JP drains for extremity sarcomas, abdominal, or thoracic tumors.
  
  
  CONCLUSIONS
  The complex brachytherapy devices fashioned from widely available surgical drains effectively guide and maintain geometry for multicatheter interstitial implants. Stable implant geometry leads to more reliable implementation of brachytherapy dosimetry. Patient comfort is improved and soft tissue injury from hard-edged buttons is avoided.
authors.affiliation: Division of Brachytherapy, Department of Radiation Oncology, University of California, Los Angeles, CA 90095-6951, USA. jdemanes@mednet.ucla.edu
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Demanes
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Friedman
authors.forename: Sang-June
authors.initials: SJ
authors.lastname: Park
authors.forename: Michael L
authors.initials: ML
authors.lastname: Steinberg
authors.forename: John K
authors.initials: JK
authors.lastname: Hayes
authors.forename: Mitchell R
authors.initials: MR
authors.lastname: Kamrava
mesh_terms: D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods*; D001943:Breast Neoplasms / Q000532:radiotherapy; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D009369:Neoplasms / Q000532:radiotherapy*