A comparison of the biological effective dose of 50-kV electronic brachytherapy with (192)Ir high-dose-rate brachytherapy for vaginal cuff irradiation
| Autor: | David E. Wazer, Jaroslaw T. Hepel, Jessica R. Hiatt, Stephanie G. MacAusland, Kathryn Huber, Edward S. Sternick, Paul Rava, Robert J. Markelewicz, Tomas Dvorak |
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| Rok vydání: | 2011 |
| Předmět: |
medicine.medical_treatment
Brachytherapy Urinary Bladder Rectum Iridium Radiation Dosage Effective dose (radiation) medicine Humans Radiology Nuclear Medicine and imaging Irradiation Radiation treatment planning Radioisotopes business.industry Endometrial cancer medicine.disease Vaginal cuff High-Dose Rate Brachytherapy Endometrial Neoplasms medicine.anatomical_structure Oncology Vagina Female business Nuclear medicine |
| Zdroj: | Brachytherapy. 11(5) |
| ISSN: | 1873-1449 |
| Popis: | Advantages for electronic brachytherapy (EBT) of the vaginal cuff include decreased physical dose to the bladder and rectum. Here we compare (192)Ir with EBT using biological effective dose (BED) to account for the different radiobiological effectiveness (RBE) predicted for low-energy x-rays.Fifteen data sets from five consecutive postoperative endometrial cancer patients treated with EBT were analyzed. Treatment planning was performed using PLATO software. The dose was prescribed as 21Gy in three fractions to a depth of 0.5cm. Physical dose, BED(3), and BED(10) were evaluated for the mucosa, bladder, and rectum. An RBE value of 1.5 was used for BED calculations.Mucosal physical dose is 28.4% greater with EBT (36.6 vs. 28.5Gy, p0.05). However, the BED(10) is increased by 79.1% (55.6 vs. 99.6Gy, p0.05) and the BED(3) by 71.5% (118.8 vs. 203.7Gy, p0.05). The physical dose (dose to 50% volume of the organ) to the bladder (9.3 vs. 6.6Gy, p0.05) and rectum (7.2 vs. 4.2Gy, p0.05) are reduced with EBT. BED(3) to the rectum and bladder are also reduced but to a lesser extent (13 vs. 8.3Gy, p0.05; 18.9 vs. 14.7Gy, p=0.06, respectively).BED takes into account the higher RBE of low-energy photons generated with EBT and provides a more accurate estimate of the biological effect. When using EBT, physical dose may underestimate the biological effect on the vaginal mucosa and overestimate the benefit for the bladder and rectum. Dose adjustment for EBT based on BED should be considered. |
| Databáze: | OpenAIRE |
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