Problems in reporting doses and volumes during multiple high-dose-rate intracavitary brachytherapy for carcinoma cervix as per ICRU Report 38: a comparative study using flexible and rigid applicators

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

doi:10.1016/s0090-8258(03)00506-7

Cited by 15 publications

(13 citation statements)

References 24 publications

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“…This conviction is based mainly on the fixed geometry applicator. It has been shown even though the applicator may have reproducible geometry, that it is difficult to insert the applicator reproducibly from one insertion to another (25). It is generally supposed that all insertions are geometrically identical to the first, so dosimetric errors at one or more of the dose points for subsequent insertions may be significant.…”

Section: Discussionmentioning

confidence: 99%

Application of mri for improved local control in complex radiotherapy of cervical cancer

et al. 2006

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Section: Discussionmentioning

confidence: 99%

Application of mri for improved local control in complex radiotherapy of cervical cancer

et al. 2006

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“…This could lead to a variation in the applicator geometry and its spatial position in relation to the pelvic organs, pelvic bony anatomy and the organs at risk [13][14][15][16][17] . These have been reported in terms of changes in the uterine axis, uterine length, slippage of tandem, colpostat separation and vaginal packing, resulting in fluctuations in spatial location of the applicator in craniocaudal axis, lateral and antero-posterior rotation as well as variation in coronal, transverse and saggital planes ( Figure 1) [18] . This has been attributed to mainly patient movement, vaginal packings and tumour regression during the interval between multiple fractions of HDR ICBT.…”

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

confidence: 94%

“…All these could result in variation in the doses to various ICRU Report 38 reporting parameters-OARs, ICRU volumes, total reference air kerma in the same patient during the course of multiple HDR ICBT [14,18,19] . Continuing to report dose to point A or ICRU Report 38 parameters, is therefore fraught with uncertainty.…”

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

confidence: 99%

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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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“…However, dose estimates at ICRU reporting points have been shown to be unreliable given practical difficulties to position the dosemeter probe accurately in the steep dose gradient regions. 12,92,93 A further argument against error criteria based on dose rates at ICRU reporting points is that modern BT is adapting volumetric dosimetry during treatment planning. 94,95 PROSPECTS FOR IN VIVO DOSIMETRY Recent developments have improved the precision and capabilities of dosimetry technology (see Novel dosimetry technology section) and also provided partial solutions to the main challenges in IVD (see Some solutions to main challenges section).…”

Section: This Error Detection Technique Was Proposed By Sheikh-baghermentioning

confidence: 99%

In vivodosimetry: trends and prospects for brachytherapy

Kertzscher¹,

Rosenfeld²,

Beddar³

et al. 2014

BJR

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The error types during brachytherapy (BT) treatments and their occurrence rates are not well known. The limited knowledge is partly attributed to the lack of independent verification systems of the treatment progression in the clinical workflow routine. Within the field of in vivo dosimetry (IVD), it is established that real-time IVD can provide efficient error detection and treatment verification. However, it is also recognized that widespread implementations are hampered by the lack of available high-accuracy IVD systems that are straightforward for the clinical staff to use. This article highlights the capabilities of the state-of-the-art IVD technology in the context of error detection and quality assurance (QA) and discusses related prospects of the latest developments within the field. The article emphasizes the main challenges responsible for the limited practice of IVD and provides descriptions on how they can be overcome. Finally, the article suggests a framework for collaborations between BT clinics that implemented IVD on a routine basis and postulates that such collaborations could improve BT QA measures and the knowledge about BT error types and their occurrence rates.

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Problems in reporting doses and volumes during multiple high-dose-rate intracavitary brachytherapy for carcinoma cervix as per ICRU Report 38: a comparative study using flexible and rigid applicators

Cited by 15 publications

References 24 publications

Application of mri for improved local control in complex radiotherapy of cervical cancer

Application of mri for improved local control in complex radiotherapy of cervical cancer

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

In vivodosimetry: trends and prospects for brachytherapy

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