Conformal Brachytherapy Planning for Cervical Cancer Using Transabdominal Ultrasound

Two-year results of transabdominal ultrasound-guided brachytherapy for cervical cancer

“…US plans vs. two-dimensional MRI were comparable for target volume ( p 5 0.11), rectal point ( p 5 0.8), and vaginal mucosa ( p 5 0.19). The local control was 90%, and late bowel morbidity (G3 and G4) was !2% (16,17). These first reports of US-guided planning of ICBT for cervical cancer also showed the agreement between different imaging modalities (MRI/US) and demonstrated very promising preliminary results of TAUS-guided planning in terms of disease control and late toxicity.…”

“…The use of US in BT planning for cervical cancer is in clinical practice and documented in a few publications. The largest study by Van Dyk et al (15,16) reports very promising first results and treatment-related toxicities.…”

Advancements in brachytherapy

“…The dose fall off is approximately 73 proportional to 1/r 2 , where r is the distance to the source [1]. Typical 74 dose gradients at the border of a target are as high as 5-20% per mm. 75 The pronounced dose gradients result in a highly heterogeneous 3D 76 dose distribution, and the median target dose is typically higher than and hypofractionation leads to a significant enhancement of the 94 biological effect leading to an ablative effect in the high dose regions.…”

Ultrasound Image Based High Dose Rate (HDR) Brachytherapy in Locally Advanced Cancer Cervix

“…In the study to determine if transabdominal USG can be used for conformal brachytherapy in cervical cancer patients, Narayan et al (5) treated seventy-one patients of locoregionally advanced disease with a minimum follow-up of 2.5 years. They observed 90% local control at 2.5 years.…”

“…Trans abdominal USG can determine uterine size, shape thickness, and diameter. There are studies that show good comparability between USG and MRI in the measurement of uterus and cervix (4,5). onal X-ray image based HDR Brachytherapy (Multisource HDR remote afterloading unit with a 60Cobalt radionuclide source) with dose prescription to point A.…”