Reporting small bowel dose in cervix cancer high-dose-rate brachytherapy
| Autor: | K Kiel, Damian Bernard, Julius V. Turian, Virag Dandekar, Y Liao, James C.H. Chu |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_treatment
Brachytherapy Rectum Uterine Cervical Neoplasms Radiation Dosage 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Intestine Small medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Cervical cancer Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Sigmoid colon Magnetic resonance imaging medicine.disease High-Dose Rate Brachytherapy Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female Nuclear medicine business Radiotherapy Image-Guided |
| Zdroj: | Medical dosimetry : official journal of the American Association of Medical Dosimetrists. 41(1) |
| ISSN: | 1873-4022 |
| Popis: | Small bowel (SB) is an organ at risk (OAR) that may potentially develop toxicity after radiotherapy for cervix cancer. However, its dose from brachytherapy (BT) is not systematically reported as in other OARs, even with image-guided brachytherapy (IGBT). This study aims to introduce consideration of quantified objectives for SB in BT plan optimization and to evaluate the feasibility of sparing SB while maintaining adequate target coverage. In all, 13 patients were included in this retrospective study. All patients were treated with external beam radiotherapy (EBRT) 45Gy in 25 fractions followed by high dose rate (HDR)-BT boost of 28Gy in 4 fractions using tandem/ring applicator. Magnetic resonance imaging (MRI) and computed tomographic (CT) images were obtained to define the gross tumor volume (GTV), high-risk clinical target volume (HR-CTV) and OARs (rectum, bladder, sigmoid colon, and SB). Treatment plans were generated for each patient using GEC-ESTRO recommendations based on the first CT/MRI. Treatment plans were revised to reduce SB dose when the [Formula: see text] dose to SB was5Gy, while maintaining other OAR constraints. For the 7 patients with 2 sets of CT and MRI studies, the interfraction variation of the most exposed SB was analyzed. Plan revisions were done in 6 of 13 cases owing to high [Formula: see text] of SB. An average reduction of 19% in [Formula: see text] was achieved. Meeting SB and other OAR constraints resulted in less than optimal target coverage in 2 patients (D90 of HR-CTV77Gyαβ10). The highest interfraction variation was observed for SB at 16 ± 59%, as opposed to 28 ± 27% for rectum and 21 ± 16% for bladder. Prospective reporting of SB dose could provide data required to establish a potential correlation with radiation-induced late complication for SB. |
| Databáze: | OpenAIRE |
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