Study of positional dependence of dose to bladder, pelvic wall and rectal points in High-Dose-Rate Brachytherapy in cervical cancer patients

Abstract

The objective of the study is to examine the variation in doses to, Bladder, pelvic wall and Rectal Points when a patient is simulated in Supine (S Position) and Lithotomy M shaped positions (LM Position), respectively as part of Intracavitary Brachytherapy in Cervical Cancer patients. Patients (n = 19) were simulated and orthogonal images were taken in S Position and LM Positions on a physical simulator. Digital orthogonal X-ray images were transferred to Brachyvision Treatment Planning System via Dicom to generate treatment plans. Radio opaque dye of 7 ml was injected into the Foley bulb for identification and digitization of International Commission on Radiological Units and Measurements (ICRU) Bladder point. Pelvic side wall points were marked in accordance with ICRU 38 recommendations. A Rectal tube containing dummy source marker wire was used to identify Rectal Point. Students’t-test was used to analyze the results. Doses in LM Position were lower and statistically significant when compared to S Position for ICRU Bladder Point, pelvic walls and Rectal Point. It was observed that movement of applicator could be the reason for the variations in doses between the two positions. Bladder, pelvic wall and rectal points systematically registered lower doses in LM Position as compared to S Position.

Folate‐Receptor‐Mediated Uptake of Carbon Dots as a pH‐Responsive Carrier for Chemotherapy

“…Cancer, recognized medically as a malicious neoplasm, is a broad group of numerous diseases, all involving uncontrolled cell growth. [1] Over 13 million deaths were projected worldwide from this deadly disease in 2030, also about 10 to 11 million cases were diagnosed each year in low and middle-income countries by 2030, according to World Health Organization. [2] Chemotherapy is used to control this deadly disease; several cycles using one drug or a combination of drugs are given to patients along with other cancer treatments like radiation therapy and surgery.…”

“…Cancer, recognized medically as a malicious neoplasm, is a broad group of numerous diseases, all involving uncontrolled cell growth [1] . Over 13 million deaths were projected worldwide from this deadly disease in 2030, also about 10 to 11 million cases were diagnosed each year in low and middle‐income countries by 2030, according to World Health Organization [2] .…”

Interfraction Variation and Dosimetric Changes in Patients With Cervical Cancer Treated With Intracavitary Brachytherapy

“… 15 Various efforts have been made to decrease the dose to the rectum and bladder, including the use of balloon catheter and lithotomy positioning. 3 , 16 The study only included patients with uterine dilatation ≤ 1 cm, as defined by the level of the flange. The reason for limiting the population was to minimize possible anatomic variation among fractions.…”

Dose variation due to change in planned position for patients with carcinoma of the cervix undergoing high-dose-rate brachytherapy- 2D dose analysis

“…In the present study, 60 plans on thirty patients with two plans per patient in S and M positions were created and analyzed. Different treatment positions are evaluated in both external beam therapy [21][22][23] and brachytherapy [24][25][26][27] for treatment of various sites. In case of brachytherapy there are studies on the use of template based standard plans versus individualized plans and pre-prepared treatment plans for curved structures such as esophagus.…”