Individualized and inverse optimized needle configuration for combined intracavitary-interstitial brachytherapy in locally advanced cervical cancer
Autor: | Wei Wang, Lin Zhou, Zeyang Zhou, Daguang Zhang, Shan Jiang, Zhiyong Yang |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Linear programming
Computer science cervical cancer medicine.medical_treatment Brachytherapy Locally advanced combined intracavitary-interstitial brachytherapy Uterine Cervical Neoplasms Inverse lcsh:RC254-282 inverse treatment planning applicators medicine Humans Radiology Nuclear Medicine and imaging In patient Precision Medicine Radiation treatment planning Simulation Neoplasm Staging Cervical cancer individualized design Radiotherapy Planning Computer-Assisted Interstitial brachytherapy Dose-Response Relationship Radiation Radiotherapy Dosage General Medicine medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Magnetic Resonance Imaging Oncology Female Radiotherapy Image-Guided |
Zdroj: | Journal of Cancer Research and Therapeutics, Vol 15, Iss 7, Pp 1589-1596 (2019) |
ISSN: | 1998-4138 0973-1482 |
Popis: | Objectives: The aim of this study is to address the limitation of combined intracavitary-interstitial (IC/IS) brachytherapy (BT) in locally advanced cervical cancer using standardized applicators and to determine the optimal dose distribution in patients with challenging tumors, innovative methods of customizing and optimizing the IS needle configuration for combined IC/IS BT are proposed and investigated. Materials and Methods: A software module that could customize the IS needle configuration and subsequently generate the digital model of guiding template for three-dimensional printing was developed and integrated into our in-house treatment planning system for BT. The inverse optimization method based on the technique of mixed-integer linear programming was introduced to determine the needle tracks out of a candidate pool and dwell times at corresponding locations to best meet dose objectives. A treatment planning study was conducted to evaluate the feasibility and performance of the proposed methods. Results: The workflow for combined IC/IS BT with customized and inverse optimized IS needle configuration was presented. Dosimetric results of the treatment planning study showed that sufficient target coverage could be obtained with the customized IS needle configuration for challenging cases. The proposed dose-based optimization method for IS needle configuration was feasible and effective. Improved target coverage and organ-at-risk sparing were achieved using the inverse planning method. Conclusions: Using the proposed methods of customizing and optimizing the IS needle configuration, the limitation in the standardized design of combined IC/IS applicators can be addressed, and sufficient target coverage is obtained in cervical cancer patients with unfavorable tumor topography and/or extra lateral expansion. |
Databáze: | OpenAIRE |
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