Journal article
DOSIMETRIC ANALYSIS OF 3D IMAGE-GUIDED HDR BRACHYTHERAPY PLANNING FOR THE TREATMENT OF CERVICAL CANCER: IS POINT A-BASED DOSE PRESCRIPTION STILL VALID IN IMAGE-GUIDED BRACHYTHERAPY?
Medical dosimetry : official journal of the American Association of Medical Dosimetrists, v 36(2), pp 166-170
2011
PMID: 20488690
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
The purpose of this study was to analyze the dosimetric outcome of 3D image-guided high-dose-rate (HDR) brachytherapy planning for cervical cancer treatment and compare dose coverage of high-risk clinical target volume (HRCTV) to traditional Point A dose. Thirty-two patients with stage IA2-IIIB cervical cancer were treated using computed tomography/magnetic resonance imaging-based image-guided HDR brachytherapy (IGBT). Brachytherapy dose prescription was 5.0-6.0 Gy per fraction for a total 5 fractions. The HRCTV and organs at risk (OARs) were delineated following the GYN GEC/ESTRO guidelines. Total doses for HRCTV, OARs, Point A, and Point T from external beam radiotherapy and brachytherapy were summated and normalized to a biologically equivalent dose of 2 Gy per fraction (EQD2). The total planned D90 for HRCTV was 80-85 Gy, whereas the dose to 2 mL of bladder, rectum, and sigmoid was limited to 85 Gy, 75 Gy, and 75 Gy, respectively. The mean D90 and its standard deviation for HRCTV was 83.2 +/- 4.3 Gy. This is significantly higher (p < 0.0001) than the mean value of the dose to Point A (78.6 +/- 4.4 Gy). The dose levels of the OARs were within acceptable limits for most patients. The mean dose to 2 mL of bladder was 78.0 +/- 6.2 Gy, whereas the mean dose to rectum and sigmoid were 57.2 +/- 4.4 Gy and 66.9 +/- 6.1 Gy, respectively. Image-based 3D brachytherapy provides adequate dose coverage to HRCTV, with acceptable dose to OARs in most patients. Dose to Point A was found to be significantly lower than the D90 for HRCTV calculated using the image-based technique. Paradigm shift from 2D point dose dosimetry to IGBT in HDR cervical cancer treatment needs advanced concept of evaluation in dosimetry with clinical outcome data about whether this approach improves local control and/or decreases toxicities. (C) 2011 American Association of Medical Dosimetrists.
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Details
- Title
- DOSIMETRIC ANALYSIS OF 3D IMAGE-GUIDED HDR BRACHYTHERAPY PLANNING FOR THE TREATMENT OF CERVICAL CANCER: IS POINT A-BASED DOSE PRESCRIPTION STILL VALID IN IMAGE-GUIDED BRACHYTHERAPY?
- Creators
- Hayeon Kim - UPMC Hillman Cancer CenterSushil Beriwal - Magee Womens Hosp, Dept Radiat Oncol, Inst Canc, Pittsburgh, PA 15213 USAChris Houser - Magee Womens Hosp, Dept Radiat Oncol, Inst Canc, Pittsburgh, PA 15213 USAM. Saiful Huq - Magee Womens Hosp, Dept Radiat Oncol, Inst Canc, Pittsburgh, PA 15213 USA
- Publication Details
- Medical dosimetry : official journal of the American Association of Medical Dosimetrists, v 36(2), pp 166-170
- Publisher
- Elsevier
- Number of pages
- 5
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000291118100009
- Scopus ID
- 2-s2.0-79955484155
- Other Identifier
- 991021897265404721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging