Brachytherapy Applicators for Gynecological Treatment: No Longer One-Size-Fits-All | Varian

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Brachytherapy Applicators for Gynecological Treatment: No Longer One-Size-Fits-All

Brachytherapy Applicators for Gynecological Treatment: No Longer One-Size-Fits-All

In the US alone, more than 110,000 new cases of gynecological cancer are diagnosed each year, with more than 32,000 deaths, according to the American Cancer Society. Varian’s commitment to creating a world without the fear of cancer has put it at the forefront of innovating effective treatment options for gynecological cancers, including brachytherapy. The recent launch of four new brachytherapy applicator sets intended for HDR or PDR brachytherapy of the vagina, cervix, uterus, endometrium, and rectum, follows through on that goal by addressing issues of applicator size, ease of use, and MRI imaging support.

Numerous studies have confirmed successful outcomes in the treatment of cervical carcinoma with an approach that combines radiation treatment (external beam and intracavitary brachytherapy) with concurrent chemotherapy, yet evidence suggests that the use of brachytherapy has been on the decline in recent years.1 Only about 50 percent of women with cervical cancer in the US receive the brachytherapy treatment they need,2 and some research points to an “inferior overall survival”3 as a result.   

The four new applicator sets are designed to help oncologists navigate the process of brachytherapy treatment more easily than ever before, and to help cancer care centers treat gynecological patients on an out-patient basis for comfort and efficiency. The previous generation of larger and bulkier applicators often require anesthesia and hospitalization, and can take a long time to insert and use for treatment. Varian’s new brachytherapy applicators help simplify the process.  These include:

  • Aarhus Applicator Set: A needle collector and two intra-vaginal templates with similar geometry to a Ring Applicator, but without a ring channel.  The templates allow for 2 mm plastic needles to be inserted through the template into the uterus.
  • Intracavitary Interstitial System: This system enables needle guide tubes to be connected to components of intracavitary applicators (e.g. ovoids from a tandem and ovoids applicator set).
  • Universal Multi-channel Cylinder Set: A set of vaginal/rectal cylinders with multiple peripheral channels. The peripheral channels allow for dose to be shaped asymmetrically to cover target volumes while reducing dose to organs at risk.
  • Universal Interstitial Cylinder Set: a set of vaginal cylinders with multiple peripheral needle-guiding holes. The needle-guiding holes allow for 2 mm plastic needles to be inserted beyond the distal end of the cylinder.

“The new suite of Varian brachytherapy applicators was designed to address the one-size-fits-all issue for women who have already been through other treatments and are dealing with extensive disease, stenosis, or tumor death,” said Sasa Mutic, PhD, senior vice president, radiation treatment solutions at Varian. “Plus, the MRI imaging support means that the clinical team can incorporate MRI imaging into the process, to better define the tumor and set the right dose.”

MR support is based on the use of sturdy and rigid materials designed to help eliminate the risk of breaking, while still being compatible with MRI techniques.

With this new suite of universal applicators, the parts in each can be shared helping to reduce the amount of stock that a clinic might need to keep on hand. For instance, all cylinder-shaped applicators can use the same central tandems. Another important benefit is the ability to use an interstitial cylinder rather than a tandem and ovoids with needles, which can help reduce treatment setup time and means insertion can be carried out with local anesthesia in clinic, rather than at a main hospital. 

“The new applicators were designed to be easier to use than previous generations and more comfortable for our patients, so clinicians can treat more patients on an out-patient basis,” explains Kevin O’Reilly, president of Varian’s Oncology Systems business.  “Having the flexibility to choose the right applicator part for treatment will help the clinical team to physically confirm where the radiation dose needs to be and create separation from organs at risk to reduce dose to other areas.”

With brachytherapy applicators that help clinicians achieve improved dose distributions and improve efficiency, Varian is helping to make effective gynecological tumor treatment more accessible to all women. 

Please note: not all products are available in all markets.

Radiation treatment may not be appropriate for all cancers. Individual results may vary.  For more information, please visit


Feghali, KAA and Elshaikh, MA. Why brachytherapy boost is the treatment of choice for most women with locally advanced cervical carcinoma? Brachytherapy. Mar-Apr 2016;15(2):191-9. doi: 10.1016/j.brachy.2015.12.003.    
Han K et al.  Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States. Int J Radiation Oncol Biol Phys. 2013. 87(1): 111-119.
Gill BS, Lin JF, Krivak TC et al.  National Cancer Data Base analysis of radiation therapy consolidation modality for cervical cancer: the impact of new technological advancements.  Int J Radiat Oncol Biol Phys. 2014 Dec 1. 90(5):1083-90.