Comparing organ-at-risk doses for high-dose-rate vaginal brachytherapy between three different planning workflows
| Autor: | Andrew O. Wahl, J. Gruhl, Dandan Zheng, J.L. Longo, Charles A. Enke |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Organs at Risk
medicine.medical_specialty health care facilities manpower and services Brachytherapy Urinary Bladder education Rectum Radiation Dosage Workflow 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine health services administration medicine Humans Radiology Nuclear Medicine and imaging Radiation treatment planning health care economics and organizations Retrospective Studies business.industry Radiotherapy Planning Computer-Assisted Endometrial cancer Radiotherapy Dosage medicine.disease Vaginal Cylinder Endometrial Neoplasms Surgery medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Organ at risk Vagina Vaginal brachytherapy Female Radiotherapy Adjuvant Tomography X-Ray Computed Nuclear medicine business Dose rate |
| Zdroj: | Brachytherapy. 16:373-377 |
| ISSN: | 1538-4721 |
| DOI: | 10.1016/j.brachy.2016.11.008 |
| Popis: | Purpose The aim of this study was to compare the organ-at-risk doses to the rectum and the bladder in postoperative endometrial cancer patients who receive high-dose-rate vaginal brachytherapy (HDR-VB), when using three different methods of treatment planning: ( Workflow A ) individualized treatment planning before every fraction, ( Workflow B ) individualized treatment planning for first fraction only), and ( Workflow C ) using a template plan based on applicator choice and prescription specifics without patient-specific imaging or planning (standardized template approach). Methods and Materials Alternative plans were retrospectively created using workflows B and C for 22 patients who previously received postoperative HDR-VB using a vaginal cylinder and planned using Workflow A for endometrial cancer. The rectum and bladder were contoured on the CTs used for each fraction for dose comparison between the three methods. D 50 , D 2cc , D 1cc , D 0.1cc , and V 100 of the bladder and the rectum were compared using the two-sided Wilcoxon signed-rank test. Results A total of 123 fractions were available for comparison. For Workflow A vs. Workflow B, there was no significant difference for any rectal or bladder dosimetric parameter. For Workflow A vs. Workflow C, Workflow A delivered a significantly higher median dose to the rectum than Workflow C for D 50 , D 2cc , D 1cc , and V 100 . Workflow C delivered a significantly higher dose to the bladder than Workflow A: D 2cc , D 1cc , D 0.1cc , and V 100 . However, the magnitudes of the differences were small; the dose index difference was >75 cGy for only two fractions. Conclusion Plan standardization in HDR-VB may result in considerable time and cost savings with minimal organ-at-risk dose differences. |
| Databáze: | OpenAIRE |
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