Journal article
Image guided adaptive brachytherapy for cervical cancer: dose contribution to involved pelvic nodes in two cancer centers
Journal of contemporary brachytherapy, v 6(1), pp 21-27
01 Jan 2014
PMID: 24790618
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Purpose: The goal of this study was to determine the dose contributions from image guided adaptive brachytherapy (IGABT) to individual suspicious pelvic lymph nodes (pLNN) in cervical cancer patients. Data were collected in two cancer centers, University of Pittsburgh Cancer Institute (UPCI) and University Medical Center Utrecht (UMCU).
Material and methods: 27 and 15 patients with node positive cervical cancer treated with HDR (high dose rate) or PDR (pulsed dose rate)-IGABT were analyzed. HDR-IGABT (UPCI) was delivered with CT/MRI compatible tandem-ring applicators with 5.0-6.0 Gy x five fractions. PDR-IGABT (UMCU) dose was delivered with Utrecht tandem-ovoid applicators with 32 x 0.6 Gy x two fractions. Pelvic lymph nodes with short axis diameter of >= 5 mm on pre-treatment MRI or PET-CT were contoured for all BT-plans. Dose contributions to individual pLNN expressed as D-90 (dose to 90% of the volume) were calculated from dose-volume histograms as absolute and relative physical dose (% of the reference dose) for each fraction. For each node, the total dose from all fractions was calculated, expressed in EQD2 (equivalent total dose in 2 Gy fractions).
Results: Fifty-seven (UPCI) and 40 (UMCU) individual pLNN were contoured. The mean D-90 pLNN was 10.8% (range 5.7-25.1%) and 20.5% (range 6.8-93.3%), respectively, and therefore different in the two centers. These values translate into 2.7 Gy (1.3-6.6 Gy) EQD2 and 7.1 Gy (2.2-36.7 Gy) EQD2, respectively. Differences are caused by the location of the individual nodes in relation to the spatial dose distribution of IGABT, differences in total dose administered and radiobiology (HDR versus PDR).
Conclusions: The IGABT dose contribution to individual pelvic nodes depends on patient and treatment related factors, and varies considerably.
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Details
- Title
- Image guided adaptive brachytherapy for cervical cancer: dose contribution to involved pelvic nodes in two cancer centers
- Creators
- Willemien van den Bos - Utrecht UniversitySushil Beriwal - UPMC Hillman Cancer CenterLaura Velema - Erasmus University RotterdamAstrid A. C. de Leeuw - Utrecht UniversityChristel N. Nomden - Utrecht UniversityIna-M. Juergenliemk-Schulz - College Station Medical Center
- Publication Details
- Journal of contemporary brachytherapy, v 6(1), pp 21-27
- Publisher
- Termedia Publishing House Ltd
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Radiation Oncology (and Nuclear Medicine)
- Web of Science ID
- WOS:000338354100005
- Scopus ID
- 2-s2.0-84899504411
- Other Identifier
- 991021897377704721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Oncology
- Radiology, Nuclear Medicine & Medical Imaging