Problems and Uncertainties with Multiple Point A's During Multiple High-dose-rate Intracavitary Brachytherapy in Carcinoma of the Cervix

Datta, Niloy Ranjan; Basu, R; Das, K.J. Maria; Rajasekar, David; Pandey, Chandra Kant; Singh, Uttam; Ayyagari, S.

doi:10.1016/j.clon.2003.10.011

Cited by 8 publications

(3 citation statements)

References 19 publications

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“…Datta et al (23) randomized 50 patients after whole-pelvis EBRT to receive three HDR BT insertions of 6 Gy to Point A with either a flexible or rigid intrauterine applicator. Orthogonal X-rays of 150 applications were assessed for applicator geometry and Point A coordinates.…”

Section: Discussionmentioning

confidence: 99%

Parametrial Boost Using Midline Shielding Results in an Unpredictable Dose to Tumor and Organs at Risk in Combined External Beam Radiotherapy and Brachytherapy for Locally Advanced Cervical Cancer

Fenkell

Assenholt

Nielsen

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionmentioning

confidence: 99%

Parametrial Boost Using Midline Shielding Results in an Unpredictable Dose to Tumor and Organs at Risk in Combined External Beam Radiotherapy and Brachytherapy for Locally Advanced Cervical Cancer

Fenkell

Assenholt

Nielsen

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…Currently the most frequently used protocols are the ICRU recommendations 38 and 89, and the protocol released by the American Brachytherapy Society (ABS) and the Groupe Européen de Curiethérapie (GEC) with the European Society for Radiotherapy & Oncology (ESTRO) known as GEC-ESTRO [11,12] ICRU 38 protocol is based on the reference volume enclosed by the reference isodose surface [13,14]. ABS recommendation use a point H and an optimization to define the dose distribution along the tandem [15].…”

Section: Introductionmentioning

confidence: 99%

Analysis in organs at risk for gynecological radiotherapy by High Dose Rate Brachytherapy using Manchester point A, ICRU 38 Report and American Braquitherapy Society recomendation

et al. 2018

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The gynecological treatment with High Dose Rate (HDR) Brachytherapy implies delivering dose to the tumor and spare the dose in organs at risk. In this work, we apply the recommendations for prescribing dose given by the International Commission of Radiation Units (ICRU) reports 38, 89 and the American Brachytherapy Society (ABS). With both schemes of optimization, recommendation of ICRU 38 or ABS with vaginal point from ICRU 89. Doses received by the organs at risk were analyzws, in this case rectum and bladder and also the irradiated volume for patients that receive HDR brachytherapy treatment. An afterloading technique is applied with an Eckert & Ziegler MultiSource ® equipment using a 60 Co source, 30 patients with 4 applications with cervical cancer are planning with HDR brachytherapy. This work analyzes 120 single applications with orthogonal images using the treatment planning system (TPS) HDRplus version 3.0.4 through "Auto dwell time determination" optimization method, using the recommendation for optimization dose from the ABS and vaginal point from ICRU 89 . The volume of the isodose curve of prescription is 15% less using ABS recommendation than ICRU 38. The bladder dose is 11% and rectum dose is 21% less using ABS recommendation than ICRU 38. The analysis of dose prescription using ICRU 38 and ABS recommendations in the patients analyzed shows less irradiated volume at the dose prescribed and also less mean dose in rectum and bladder of applications using ABS in contrast with ICRU 38 recommendations.

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“…The variation in the applicator position in successive brachytherapy sessions, results in varying location of point A, as it is primarily defined in relation to the applicator itself [14,19,20] . Multiple HDR applications, thus result in different set of point As for both right and left sides, each set corresponding to each application.…”

Section: Dose Prescriptions In Hdr Era Using Point a And Icru Report 38mentioning

confidence: 99%

Brachytherapy in cancer cervix: Time to move ahead from point A?

Srivastava¹

2014

WJCO

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Brachytherapy forms an integral part of the radiation therapy in cancer cervix. The dose prescription for intracavitary brachytherapy (ICBT) in cancer cervix is based on Tod and Meredith's point A and has been in practice since 1938. This was proposed at a time when accessibility to imaging technology and dose computation facilities was limited. The concept has been in practice worldwide for more than half a century and has been the fulcrum of all ICBT treatments, strategies and outcome measures. The method is simple and can be adapted by all centres practicing ICBT in cancer cervix. However, with the widespread availability of imaging techniques, clinical use of different dose-rates, availability of a host of applicators fabricated with image compatible materials, radiobiological implications of dose equivalence and its impact on tumour and organs at risk; more and more weight is being laid down on individualised image based brachytherapy. Thus, computed tomography, magnetic-resonance imaging and even positron emission computerized tomography along with brachytherapy treatment planning system are being increasingly adopted with promising outcomes. The present article reviews the evolution of dose prescription concepts in ICBT in cancer cervix and brings forward the need for image based brachytherapy to evaluate clinical outcomes. As is evident, a gradual transition from "point" based brachytherapy to "profile" based image guided brachytherapy is gaining widespread acceptance for dose prescription, reporting and outcome evaluation in the clinical practice of ICBT in cancer cervix.

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Problems and Uncertainties with Multiple Point A's During Multiple High-dose-rate Intracavitary Brachytherapy in Carcinoma of the Cervix

Cited by 8 publications

References 19 publications

Parametrial Boost Using Midline Shielding Results in an Unpredictable Dose to Tumor and Organs at Risk in Combined External Beam Radiotherapy and Brachytherapy for Locally Advanced Cervical Cancer

Parametrial Boost Using Midline Shielding Results in an Unpredictable Dose to Tumor and Organs at Risk in Combined External Beam Radiotherapy and Brachytherapy for Locally Advanced Cervical Cancer

Analysis in organs at risk for gynecological radiotherapy by High Dose Rate Brachytherapy using Manchester point A, ICRU 38 Report and American Braquitherapy Society recomendation

Brachytherapy in cancer cervix: Time to move ahead from point A?

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