Ring Versus Ovoids and Intracavitary Versus Intracavitary-Interstitial Applicators in Cervical Cancer Brachytherapy: Results From the EMBRACE I Study
| Autor: | Christian Kirisits, Ina M. Jürgenliemk-Schulz, Bernard Oosterveld, Robert Hudej, Richard Pötter, Peter Bownes, Kees Koedooder, Gerry Lowe, Astrid de Leeuw, Jacob Christian Lindegaard, Marisol De Brabandere, Arun S Oinam, Monica Serban, Taran Paulsen Hellebust, Kari Tanderup, Anne Beate Langeland Marthinsen, Geetha Menon, Diane Whitney, Jamema Swamidas, Nicole Nesvacil |
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| Přispěvatelé: | Academic Medical Center |
| Rok vydání: | 2020 |
| Předmět: |
Organs at Risk
Cancer Research medicine.medical_treatment Brachytherapy Uterine Cervical Neoplasms Rectum Large target 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Humans Medicine Radiology Nuclear Medicine and imaging Cervical cancer Radiation business.industry Radiotherapy Dosage Middle Aged medicine.disease Target dose Observational Studies as Topic medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Female business Nuclear medicine |
| Zdroj: | Serban, M, Kirisits, C, de Leeuw, A, Pötter, R, Jürgenliemk-Schulz, I, Nesvacil, N, Swamidas, J, Hudej, R, Lowe, G, Hellebust, T P, Menon, G, Oinam, A, Bownes, P, Oosterveld, B, De Brabandere, M, Koedooder, K, Langeland Marthinsen, A B, Whitney, D, Lindegaard, J, Tanderup, K & EMBRACE Collaborative Group 2020, ' Ring Versus Ovoids and Intracavitary Versus Intracavitary-Interstitial Applicators in Cervical Cancer Brachytherapy : Results From the EMBRACE I Study ', International Journal of Radiation Oncology Biology Physics, vol. 106, no. 5, pp. 1052-1062 . https://doi.org/10.1016/j.ijrobp.2019.12.019 International Journal of Radiation Oncology Biology Physics, 106(5), 1052-1062. Elsevier Inc. |
| ISSN: | 0360-3016 |
| DOI: | 10.1016/j.ijrobp.2019.12.019 |
| Popis: | Purpose: The aim of this study was to investigate the influence of brachytherapy technique and applicator type on target dose, isodose surface volumes, and organ-at-risk (OAR) dose. Methods and Materials: Nine hundred two patients treated with tandem/ovoids (T&O) (n = 299) and tandem/ring (T&R) (n = 603) applicators from 16 EMBRACE centers were analyzed. Patients received external beam radiation therapy and magnetic resonance imaging guided brachytherapy with dose prescription according to departmental practice. Centers were divided into 4 groups, according to applicator/technique: Ovoids and ring centers treating mainly with the intracavitary (IC) technique and ovoids and ring centers treating routinely with the intracavitary/interstitial (IC/IS) technique. V85Gy EQD210, CTVHR D90% (EQD210), and bladder, rectum, sigmoid, and vaginal 5-mm lateral-point doses (EQD23) were evaluated among center groups. Differences between T&O and T&R were tested with multivariable analysis. Results: For similar point A doses, mean CTVHR D90% was 3.3 Gy higher and V85Gy was 23% lower for ring-IC compared with ovoids-IC centers (at median target volumes). Mean bladder/rectum doses (D2cm3 and ICRU-point) were 3.2 to 7.7 Gy smaller and vaginal 5-mm lateral-point was 19.6 Gy higher for ring-IC centers. Routine use of IC/IS technique resulted in increased target dose, whereas V85Gy was stable (T&R) or decreased (T&O); reduced bladder and rectum D2cm3 and bladder ICRU-point by 3.5 to 5.0 Gy for ovoids centers; and similar OAR doses for ring centers. CTVHR D90% was 2.8 Gy higher, bladder D2cm3 4.3 Gy lower, rectovaginal ICRU-point 4.8 Gy lower, and vagina 5-mm lateral-point 22.4 Gy higher for ring-IC/IS versus ovoids-IC/IS centers. The P values were |
| Databáze: | OpenAIRE |
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