Dosimetric Comparison of Tandem and Ovoids vs. Tandem and Ring for Intracavitary Gynecologic Applications

Levin, D.; Menhel, J.; Rabin, Tanya; Pfeffer, M. Raphael; Symon, Zvi

doi:10.1016/j.meddos.2008.06.003

Cited by 15 publications

(17 citation statements)

References 15 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The definitive treatment of LACC includes both pelvic EBRT with concomitant platinum-based chemotherapy and BRT boost to the central disease. TO and TR are the two most common intracavitary BRT applicators used in the treatment of LACC [1,2,3,4,18,20,21]. TO applicator is the variation of traditional Manchester, Fletcher, Henschke systems, and TR applicator is derived from the Stockholm system [18].…”

Section: Discussionmentioning

confidence: 99%

“…TR applicators have recently come into widespread use in IGBT of cervical cancer due to the easiness of application compared to TO applicators. Additionally, it has a predictable and fixed geometry [20,21,29]. All these physical properties of TR applicator make it more advantageous in clinical use.…”

Section: Discussionmentioning

confidence: 99%

“…All these physical properties of TR applicator make it more advantageous in clinical use. Although TR applicator can be used in all patient groups requiring intracavitary BRT, patients with non-bulky disease, superficial or obliterated vaginal fornix, or narrow vaginal cavity are the ideal patients' group in cervical cancer [20,21,29]. In addition to applicator geometries, a retraction method play an important role to place away rectum from radiation source and to increase the conformity of the BRT treatment plan [22].…”

Section: Discussionmentioning

confidence: 99%

“…Nowadays,192 Ir-based high-dose-rate (HDR) systems and BRT applicators compatible with these systems are widely used in clinics [18]. Although there are various type of intracavitary BRT applicators as defined in ICRU report 89 [18], tandem-ovoids (TO) and tandem-ring (TR) are the two most common used applicators in LACC [20,21]. Additionally, intracavitary BRT application requires an appropriate retraction method to place away rectum and bladder from radiation sources.…”

Section: Purposementioning

confidence: 99%

“…This can be attributed to the fact that total volume receiving dose greater than or equal to the prescribed reference dose in external body was found to be higher in TO than in TR applicator. Ma et al [20] and Levin et al [21] also reported that contoured target volumes were smaller in TR compared to TO applicators. Similar differences were observed in the present study, and the differences in delineated volumes can be attributed to the geometric design of TO applicator, allowing for wider transverse displacement of the CTV HR and CTV IR volumes at the level of the ovoids, when compared with ring applicator.…”

mentioning

confidence: 98%

See 4 more Smart Citations

Dosimetric comparison of two different applicators and rectal retraction methods used in inverse optimization-based intracavitary brachytherapy for cervical cancer

Biltekin

Gültekin

Yilmaz

et al. 2020

jcb

View full text Add to dashboard Cite

Purpose: The purpose of this study was to evaluate the dosimetric differences between two different applicators and rectal-retraction methods used in image-guided brachytherapy (IGBT) for locally advanced cervical cancer (LACC). Material and methods: Ten patients with LACC treated with definitive chemoradiotherapy and inverse optimization-based IGBT were included in this study. In each patient, at least one fraction of IGBT was performed using tandem-ovoids (TO) with vaginal gauze packing (VGP) or tandem-ring (TR) with rectal-retractor (RR). High-risk clinical target volume (CTV HR) and intermediate-risk CTV (CTV IR) were defined as CTVs, and bladder, rectum, sigmoid, small bowel, urethra, and vaginal mucosa were defined as organs at risk (OARs). All patients received 50.4 Gy external beam radiotherapy (EBRT) in 28 fractions. After EBRT, 28 Gy high-dose-rate (HDR) IGBT in 4 fractions was delivered to central disease. A plan comparison was performed using dose-volume histogram (DVH) and treatment planning parameters for CTVs and OARs. Results: There were no significant differences in D 90 values of CTV HR. In terms of rectum dose, TR with RR was found to be significantly better than TO with VGP (p < 0.0001 for D 2cm3 and p < 0.013 for V 5Gy). Although, there were no statistically significant differences in D 2cm3 value of bladder, sigmoid, small bowel, upper vaginal mucosa, and urethra, mean value of D 2cm3 for all defined OARs were found lower in TR than in TO. Bladder V 7Gy , upper vaginal mucosa V 7Gy , middle and lower vaginal mucosa D 2cm3 values were all found to be significantly lower for TR than for TO (p < 0.035). CTV HR and CTV IR volumes contoured in TR were approximately 11% and 9% smaller than TO, respectively. Conclusions: The results showed that there were no statistically differences in D 90 value of CTV HR and CTV IR. However, all DVH parameters for OARs in TR with RR were found to be better than in TO with VGP.

show abstract