scholarly journals Intra-fractional dosimetric analysis of image-guided intracavitary brachytherapy of cervical cancer

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Junfang Yan ◽  
Jiawei Zhu ◽  
Kai Chen ◽  
Lang Yu ◽  
Fuquan Zhang
Keyword(s):  
Cervical Cancer ◽  
Treatment Planning ◽  
Organs At Risk ◽  
Cone Beam Ct ◽  
Ct Scanning ◽  
Target Volume ◽  
High Dose Rate ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Image Guided

Abstract Background To assess the intra-fractional dosimetric variations of image-guided brachytherapy of cervical cancer. Methods A total of 38 fractions (9 patients) undergoing brachytherapy for cervical cancer underwent a CT scanning for treatment planning (planning CT) and a Cone-beam CT (CBCT) scanning immediately prior to delivery (pre-delivery CBCT). The variations of volumes as well as the dosimetric impact from treatment planning to delivery (intra-application) were evaluated. The dose volume histogram parameters including volume, D90 of high-risk clinical target volume (HRCTV) and D2cc of organs at risk (OARs) were recorded. Results The relative differences (mean ± 1SD) of the volume and D90 HRCTV across the two scans were − 2.0 ± 3.3% and − 1.2 ± 4.5%, respectively. The variations of D2cc for bladder, rectum, sigmoid and small intestine are − 0.6 ± 17.1%, 9.3 ± 14.6%, 7.2% ± 20.5% and 1.5 ± 12.6%, respectively. Most of them are statistically nonsignificant except the D2cc for rectum, which showed a significant increase (P = 0.001). Using 5% and 10% uncertainty of physical dose for HRCTV at a 6 Gy × 5 high-dose-rate schedule, the possibility of total equivalent doses in 2 Gy fractions (EQD2) lower than 85 Gy is close to 0% and 3%, respectively. Performing similar simulation at 15% and 20% uncertainty of a 4 Gy physical dose for OARs, the possibility of total EQD2 dose exceeding 75 Gy is about 70%. Less than 1% of the total EQD2 of OARs would exceed 80 Gy. Conclusions Average intra-fractional dosimetric variation of HRCTV was small in an interval of less than 1 h, and the possibility of total EQD2 exceeding 85 Gy is higher than 97%. The intra-fractional dosimetric variations of OARs might result in an overdose for OARs in a single fraction or the whole treatment. It is necessary to detect unfavorable anatomical changes by re-imaging and take interventions to minimize applied doses and reduce the risk of complications.

scholarly journals Image guided high-dose-rate brachytherapy versus volumetric modulated arc therapy for head and neck cancer: A comparative analysis of dosimetry for target volume and organs at risk

2018 ◽  
Vol 52 (4) ◽  
pp. 461-467
Author(s):  
Hironori Akiyama ◽  
Csilla Pesznyák ◽  
Dalma Béla ◽  
Örs Ferenczi ◽  
Tibor Major ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Dose Rate ◽  
Organs At Risk ◽  
Volumetric Modulated Arc Therapy ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Image Guided ◽  
Arc Therapy

Abstract Background The aim of the study was to present dosimetric comparison of image guided high-dose-rate brachytherapy (IGBT) with volumetric modulated arc therapy (VMAT) for head and neck cancer regarding conformity of dose distribution to planning target volume (PTV) and doses to organs at risk (OARs). Patients and methods Thirty-eight consecutive patients with T1-4 mobile tongue, floor of mouth and base of tongue cancer treated with IGBT were selected. For these patients additional VMAT treatment plans were also prepared using identical computed tomography data. OARs and PTV related parameters (e.g. V98, D0.1cm3, Dmean, etc.) were compared. Results Mean V98 of the PTV was 90.2% vs. 90.4% (p > 0.05) for IGBT and VMAT, respectively. Mean D0.1cm3 to the mandible was 77.0% vs. 85.4% (p < 0.05). Dmean to ipsilateral and contralateral parotid glands was 4.6% vs. 4.6% and 3.0% vs. 3.9% (p > 0.05). Dmean to ipsilateral and contralateral submandibular glands was 16.4% vs. 21.9% (p > 0.05) and 8.2% vs. 16.9% (p < 0.05), respectively. Conclusions Both techniques showed excellent target coverage. With IGBT dose to normal tissues was lower than with VMAT. The results prove the superiority of IGBT in the protection of OARs and the important role of this invasive method in the era of new external beam techniques.

Severe Gastrointestinal Complications in the Era of Image-guided High-dose-rate Intracavitary Brachytherapy for Cervical Cancer

2015 ◽  
Vol 37 (1) ◽  
pp. 49-60 ◽  
Author(s):  
Daniel M. Trifiletti ◽  
W. Tyler Watkins ◽  
Linda Duska ◽  
Bruce B. Libby ◽  
Timothy N. Showalter
Keyword(s):  
Cervical Cancer ◽  
Dose Rate ◽  
High Dose Rate ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Gastrointestinal Complications ◽  
Image Guided

scholarly journals Cervical cancer brachytherapy amid the COVID-19 pandemic: A single institutional case series

2021 ◽  
Author(s):  
Zahra Siavashpour ◽  
Mahdi Aghili ◽  
Ramin Jaberi ◽  
Anya Jafari ◽  
Fatemeh Jafari
Keyword(s):  
Cervical Cancer ◽  
Treatment Time ◽  
Organs At Risk ◽  
Locally Advanced ◽  
Case Series ◽  
Target Volume ◽  
High Dose Rate ◽  
High Dose ◽  
Overall Treatment Time ◽  
Dose Constraints

Dose escalation to target volume during High Dose Rate brachytherapy was effectively employed to treat locally advanced cervical cancer patients who experienced prolongation of overall treatment time (OTT) due to the COVID-19 pandemic. It was tried to achieve acceptable oncological outcomesو while respecting the dose constraints of organs at risk.

scholarly journals Impact of different treatment plans on EQD2 for intracavitary brachytherapy of cervical cancer

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Osman Vefa Gul ◽  
Gokcen Inan ◽  
Hamit Basaran
Keyword(s):  
Cervical Cancer ◽  
Small Intestine ◽  
Organs At Risk ◽  
External Beam Radiotherapy ◽  
High Dose Rate ◽  
Intracavitary Brachytherapy ◽  
High Dose ◽  
Dose Volume Histograms ◽  
Significant Difference ◽  
Treatment Plans

Abstract Background Cancer is one of the leading causes of death worldwide. According to GLOBOCAN estimates, there were 341,831 deaths from cervical cancer in 185 countries in 2020. The aim of this study was to compare equieffective dose (EQD2) at 2 Gy per fraction by using dose volume histograms (DVHs) derived from external beam radiotherapy (EBRT) and high-dose rate brachytherapy (HDR-BRT) treatment plans used in cervical cancer radiotherapy. Methods Fifteen patients with stage IIB-IIIB cervical cancer were included in this retrospective study. Treatment with three-dimensional conformal radiotherapy (3D-CRT) or intensity-modulated radiotherapy (IMRT) was planned for all patients in 28 fractions, with a total of 50.4 Gy to be delivered to the whole pelvic region. After EBRT, manual optimization (MO) or inverse optimization (IO) HDR-BRT plans were created in 4 fractions with a total of 28 Gy. The plans obtained were grouped as IMRT + IO, IMRT + MO, 3DCRT + IO, and 3DCRT + MO by calculating EQD2s among these plans. D90, D95, and D98 values were compared in all plans for CTVHR total EQD2. In addition, EQD2 values ​for critical organs at risk (OARs) such as rectum, bladder, small intestine, and sigmoid were compared in all plans for volumes of 2 cm3, 1 cm3, and 0.1 cm3, respectively. Results There was no significant difference between the treatment groups in terms of CTVHR D90 and CTVIR D90 values; However, CTVHR D95 (p = 0.000) and CTVHR D98 (p = 0.000) values ​were found to be better in IMRT + IO technique. The IMRT + IO technique provided better protection for 2 cm3, 1 cm3, and 0.1 cm3 volumes of OARs compared to other techniques. Conclusions Considering all parameters such as CTVHR, CTVIR, rectum, bladder, small intestine, and sigmoid, combination of IMRT + IO treatment option was found to be significantly superior in total EQD2 calculations compared to other plans.

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