Evidence-Based Dose Planning Aims and Dose Prescription in Image-Guided Brachytherapy Combined With Radiochemotherapy in Locally Advanced Cervical Cancer

Dosimetric impact of target definition in brachytherapy for cervical cancer – Computed tomography and trans rectal ultrasound versus magnetic resonance imaging

“…CTV HR D 98 represents the spatial dose distribution within and at borders of the target volumes. This DVH parameter is relevant for plan evaluation and the detection of low dose regions not reflected in D 90 [31] . Although the dose to CTV HR-CT was systematically smaller by 1 ± 10 Gy α/β=10 , as compared to CTV HR-MR , the number of patients not meeting the constraint may be attributed to the contouring uncertainties inherent to D 98 [31] .…”

“…This DVH parameter is relevant for plan evaluation and the detection of low dose regions not reflected in D 90 [31] . Although the dose to CTV HR-CT was systematically smaller by 1 ± 10 Gy α/β=10 , as compared to CTV HR-MR , the number of patients not meeting the constraint may be attributed to the contouring uncertainties inherent to D 98 [31] . The current methodology of delineation of CTV HR may be safe to adopt, with respect to the threshold doses established for MR IGABT.…”

Image-guided brachytherapy in cervical cancer including fractionation

“…Schedules with 45 Gy external beam radiation require larger brachytherapy dose contribution, potentially more brachytherapy fractions, and higher demands on the brachytherapy quality (such as the availability of intracavitary/interstitial implants). 17 It is recommended that brachytherapy be applied during weeks 6-7 of treatment. 24 A frequently used fractionation schedule for imageguided adaptive brachytherapy includes 45 Gy external beam radiation combined with four fractions of image-guided adaptive brachytherapy, which may be delivered in two applicator insertions.…”

“…Summary of dose-effect and volume-effect relationships for endpoints relevant for brachytherapy and the currently recommended soft and hard constraints (modified according to Tanderup et al17 ). The table is based on an update of the EMBRACE II constraints which are found in the EMBRACE II protocol24 Gy for organs at risk; EQD2 10 , equivalent dose in 2 Gy fractions (EQD2) using alpha/beta ratios of 10 Gy for tumour volumes; high-risk clinical target volume, adaptive high-risk clinical target volume.…”

How to PROceed? Reviewing obstacles and perspectives in patient-centered digital care in radiation oncology

“…Evidently, groundbreaking progress has been made in the past two decades [1][2][3][4][5][6]. Therapeutic strategies are becoming increasingly complex and involve a broad variety of individual medical specialists [7,8]. Inherent to the great opportunities of nowadays, oncology lays several risks that threaten both the success of treatment and patients' wellbeing such as missing hints of undesired side effects in early stages.…”