Do changes in interfraction organ at risk volume and cylinder insertion geometry impact delivered dose in high-dose-rate vaginal cuff brachytherapy?

Patel, Shyamal; Mehta, Keyur; Kuo, Hsiang-Chi; Ohri, Nitin; Patel, R.; Ravi, Ananth; Garg, Madhur; Guha, Chandan

doi:10.1016/j.brachy.2015.11.004

Cited by 7 publications

(8 citation statements)

References 21 publications

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“…Nonsignificant rectal D 2cc differences among planned and delivered brachytherapy fractions (14.25 vs 13.95 Gy, p = 0.155) were observed in a recent study 79. In that study, a nonsignificant decrease in rectal volumes on the delivered CTs was observed compared to the planning CT. A positive correlation has been demonstrated between rectal volume and D max , D0.1cc, D 1cc and D 2cc , which remained significant in multiple linear regression models 32.…”

Section: Rectum Volumementioning

confidence: 74%

“…Patel et al79 observed lower bladder volumes on planning CT compared with the treatment CT acquired before each brachy-therapy fraction. At the same time, the delivered bladder D 2cc was significantly higher than the planned D 2cc (18.83 vs 13.2 Gy, p = 0.0053).…”

Section: Bladder Volumementioning

confidence: 98%

“…The “natural” angle position of the cylinder,31 which tips the cylinder points posteriorly, has been linked to an increase in the rectal dose, while cylinders placed horizontally reduced rectal doses and increased the bladder values 32. Nevertheless, one study failed to demonstrate a correlation between the cylinder angle and the bladder dose although a posterior angle increased rectal D 2cc 79…”

Section: Applicator Type and Position Patient Position And Volume Tomentioning

confidence: 99%

“…Nowadays, simulation for postoperative EC relies on CT volumetric images, which have proven to detect air pockets around the cylinders74,76,77 or inside the rectum84 or evaluate bladder volume79 and improve dose deposition. Magnetic resonance imaging (MRI) is considered the optimal imaging method to delineate volumes in cervical cancer,99 but its value in EC is less clear and availability is limited, so strategies to integrate clinical images into the radiotherapy workflow have been studied 100.…”

Section: Custom or Standard Radiotherapy Planningmentioning

confidence: 99%

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Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Sabater¹,

Andrés²,

Lopez-Honrubia³

et al. 2017

CMAR

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Endometrial cancer (EC) is one of the most common gynecological cancers among women in the developed countries. Vaginal cuff is the main location of relapses after a curative surgical procedure and postoperative radiation therapy have proven to diminish it. Nevertheless, these results have not translated into better survival results. The preeminent place of vaginal cuff brachytherapy (VCB) in the postoperative treatment of high- to intermediate-risk EC was given by the PORTEC-2 trial, which demonstrated a similar reduction in relapses with VCB than with external beam radiotherapy (EBRT), but VCB induced less late toxicity. As a result of this trial, the use of VCB has increased in clinical practice at the expense of EBRT. A majority of the clinical reviews of VCB usually address the risk categories and patient selection but pay little attention to technical aspects of the VCB procedure. Our review aimed to address both aspects. First of all, we described the risk groups, which guide patient selection for VCB in clinical practice. Then, we depicted several technical aspects that might influence dose deposition and toxicity. Bladder distension and rectal distension as well as applicator position or patient position are some of those variables that we reviewed.

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Section: Rectum Volumementioning

confidence: 74%

Section: Bladder Volumementioning

confidence: 98%

Section: Applicator Type and Position Patient Position And Volume Tomentioning

confidence: 99%

Section: Custom or Standard Radiotherapy Planningmentioning

confidence: 99%

See 2 more Smart Citations

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Sabater¹,

Andrés²,

Lopez-Honrubia³

et al. 2017

CMAR

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show abstract

“…For the total EQD 2 VCB , we used the initial rectal dose statistics in the first fraction of VCB for two subsequent imaginary fractions. Significant variation in rectal dose should not be expected among the three fractions of VCB when differences in cylinder position or angle are excluded, considering the common clinical practice of performing the fractions of VCB based on the initial planning CT [25]. …”

Section: Discussionmentioning

confidence: 99%

Effects of vaginal cylinder position on dose distribution in patients with endometrial carcinoma in treatment of vaginal cuff brachytherapy

Özdemir

Dolek

Onal

2017

jcb

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PurposeTo investigate the impact of different cylinder positions on dosimetry of critical structures in patients with endometrial carcinoma undergoing three-dimensional image-based vaginal cuff brachytherapy (VCB).Material and methodsWe delivered VCB at a dose of 4 Gy to a depth of 5 mm in the vaginal cuff of 15 patients using three different cylinder positions (neutral [N], parallel [P], and angled [A]) according to the longitudinal axis of the patient. We analyzed the dose-volume distribution and volumetric variability of the rectum and bladder. We converted the total doses to equivalent doses in 2 Gy (EQD2) using a linear-quadratic model (a/b = 3 Gy).ResultsThe mean rectum volume for the N, P, and A positions was 68.2 ± 22.7 cc, 79.3 ± 33.7 cc, and 74.2 ± 29.6 cc, respectively. The mean rectum volume for the P position was significantly larger than that for the N position (p = 0.03). Relative to the N position, the A position resulted in a lower total EQD2 in the highest irradiated 2 cc (D2cc; p = 0.001), 1 cc (D1cc; p = 0.004), and 0.1 cc (D0.1cc; p = 0.047) of the rectum. Similarly, the P position resulted in a lower EQD2 in the D2cc (p = 0.018) and D1cc (p = 0.024) of the rectum relative to the N position. In the bladder, the P position resulted in a higher EQD2 in the D2cc relative to the N position (p = 0.02). There was no dosimetric difference between the P and A positions in either the rectum or the bladder.ConclusionsVaginal cuff brachytherapy in the P and A positions is significantly superior to that in the N position in terms of rectum dosimetry. The bladder dose in the N position is considerably lower than that in the other positions.

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Statistical Analysis of Interfraction Dose Variations of High-Risk Clinical Target Volume and Organs at Risk for Cervical Cancer High-Dose-Rate Brachytherapy

Washington

Randall²,

Fabian³

et al. 2022

Advances in Radiation Oncology

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Do changes in interfraction organ at risk volume and cylinder insertion geometry impact delivered dose in high-dose-rate vaginal cuff brachytherapy?

Cited by 7 publications

References 21 publications

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Effects of vaginal cylinder position on dose distribution in patients with endometrial carcinoma in treatment of vaginal cuff brachytherapy

Statistical Analysis of Interfraction Dose Variations of High-Risk Clinical Target Volume and Organs at Risk for Cervical Cancer High-Dose-Rate Brachytherapy

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Do changes in interfraction organ at risk volume and cylinder insertion geometry impact delivered dose in high-dose-rate vaginal cuff brachytherapy?

Cited by 7 publications

References 21 publications

Vaginal cuff brachytherapy in endometrial cancer &ndash; a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer &ndash; a technically easy treatment?

Effects of vaginal cylinder position on dose distribution in patients with endometrial carcinoma in treatment of vaginal cuff brachytherapy

Statistical Analysis of Interfraction Dose Variations of High-Risk Clinical Target Volume and Organs at Risk for Cervical Cancer High-Dose-Rate Brachytherapy

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Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?

Vaginal cuff brachytherapy in endometrial cancer – a technically easy treatment?