Evaluation of Volumetric Doses of Organs at Risk in Carcinoma Cervix Patients with HDR Intracavitary Brachytherapy and Comparison of CT-based and Conventional Plans

Overview

Journal J Biomed Phys Eng

Publisher Shiraz University of Medical Sciences

Specialty Biomedical Engineering

Date 2020 Feb 11

PMID 32039090

Citations 2

Authors

S Srivastava

N K Painuly

S P Mishra

K Srivastava

N Singh

S Singh

M L B Bhatt

Affiliations

Soon will be listed here.

Abstract

Background: Brachytherapy treatment planning in cervix carcinoma patients using two dimensional (2D) orthogonal images provides only point dose estimates while CT-based planning provides volumetric dose assessment helping in understanding the correlation between morbidity and the dose to organs at risk (OARs) and treatment volume.

Objective: Aim of present study is to compare International Commission on Radiation Units and Measurements Report 38 (ICRU 38) reference point doses to OARs with volumetric doses using 2D images and CT images in patients with cervical cancer.

Material And Methods: In this prospective study, 20 patients with cervical cancer stages (IIB-IIIB) were planned for a brachytherapy dose of 7Gy per fraction for three fractions using 2D image-based treatment plan and CT-based plan. ICRU 38 points for bladder and rectum were identified on both 2D image-based plan and CT-based plan and doses (D) at these points were compared to the minimum dose to 2cc volume (D) of bladder and rectum receiving the highest dose.

Results: D bladder dose was 1.60 (±0.67) times more than D bladder dose whereas D rectum dose was 1.13±0.40 times D. Significant difference was found between D and D dose for bladder (p=.0.016) while no significant difference was seen between D and D dose for rectum (p=0.964).

Conclusion: The study suggests that ICRU 38 point doses are not the true representation of maximum doses to OARs. CT-based treatment planning is more a reliable tool for OAR dose assessment than the conventional 2D radiograph-based plan.

Citing Articles

Radiobiological and dosimetric comparison of 60Co versus 192Ir high-dose-rate intracavitary-interstitial brachytherapy for cervical cancer.

Wen A, Wang X, Wang B, Yan C, Luo J, Wang P Radiat Oncol. 2022; 17(1):206.

PMID: 36514118 PMC: 9749337. DOI: 10.1186/s13014-022-02170-8.

Volume Delineation in Cervical Cancer With T2 and Diffusion-weighted MRI: Agreement on Volumes Between Observers.

Rosa C, Delli Pizzi A, Augurio A, Caravatta L, DI Tommaso M, Mincuzzi E In Vivo. 2020; 34(4):1981-1986.

PMID: 32606170 PMC: 7439893. DOI: 10.21873/invivo.11995.

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