Treatment planning for high dose rate brachytherapy of cervical cancer based on total dose constraints
Saudi Medical Journal. 2011; 32 (5): 495-503
em Inglês
| IMEMR
| ID: emr-109367
ABSTRACT
To compare the inverse planning optimization based on total dose constraints versus conventional treatment plan [point A planning method] for cervical carcinoma, and evaluate the benefit of CT-based image-guided brachytherapy. We prospectively analyzed data of 10 consecutive patients with cervical cancer treated with external beam radiotherapy to the whole pelvis [45 Gy in 25 fractions] followed by high-dose-rate [HDR] brachytherapy [21 Gy in 3 fractions]. For treatment planning of HDR brachytherapy, the basic equations of the linear-quadratic model were used to calculate the physical dose for each brachytherapy fraction needed to achieve a given total iso-effective dose for the whole treatment. Specific dosimetric parameters are evaluated for high risk [HR CTV], intermediate risk [IR CTV] clinical target volumes, and organs at risk [OARs]. In conventional plans, the HR CTV was well covered in only 15/31, and the IR CTV in 7/31 of the brachytherapy implants, while dose constraints of OARs bladder and rectum were respected in 28/31 and 14/31 implants. After optimization, the HR CTV and IR CTV dose constraints were respected in all the implants, and the bladder and rectum of cases dose constraints were respected in 25/31 and 17/31 of cases. Point A is a poor surrogate of target dose. Significant differences between point doses and dose volume histogram parameters indicate the need for inverse planning in image-guided brachytherapy of cervical cancer
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Índice:
IMEMR (Mediterrâneo Oriental)
Assunto principal:
Braquiterapia
/
Protocolos Clínicos
/
Estudos Prospectivos
/
Resultado do Tratamento
/
Protocolos Antineoplásicos
Tipo de estudo:
Guia de Prática Clínica
Limite:
Feminino
/
Humanos
Idioma:
Inglês
Revista:
Saudi Med. J.
Ano de publicação:
2011
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