The Implementation of the Gynaecological Groupe Européen de Curiethérapie – European Society for Therapeutic Radiology and Oncology Radiobiology Considerations in the Conversion of Low Dose Rate to Pulsed Dose Rate Treatment Schedules for Gynaecological Brachytherapy

Baker, S.; Pooler, Alistair; Hendry, Jolyon H; Davidson, Susan E

doi:10.1016/j.clon.2012.11.005

Cited by 3 publications

(12 citation statements)

References 16 publications

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“…These PDR cycle numbers are consistent with those of 26 and 38 cycles (of exactly 1 Gy), respectively, calculated using the GEC-ESTRO recommendations [6].…”

Section: Discussionsupporting

confidence: 66%

“…by an average of 5.8% for these cervical treatments [6]. This implied a small therapeutic advantage of PDR vs LDR owing to lowering the average dose rate from around 1.5 to 1 Gy h 21 .…”

Section: Discussionmentioning

confidence: 99%

“…In both cases, the EB component remains the same for PDR as for LDR [20]. The equivalent PDR doses were calculated [6] using generic values of the relevant parameters, i.e. a/b510 Gy (Point A) and 3 Gy (OAR), T 1/2 5 1.5 h, dose reduction factor (DRF) at the OAR50.7, as in the GEC-ESTRO recommendations [5].…”

Section: Clinical Backgroundmentioning

confidence: 99%

“…At the Christie Hospital in Manchester, UK, PDR has been implemented in place of LDR for the BT component of a combined external beam (EB) and BT treatment of cervical carcinoma [4]. The Groupe Europeen de Curietherapie-European Society for Radiotherapy & Oncology (GEC-ESTRO) recommendations [5] were used to calculate the equivalent prescribed doses of PDR BT compared with those of the formerly used LDR-BT protocol [6]. Those guidelines use generic values of linear-quadratic parameters and monophasic repair kinetics.…”

mentioning

confidence: 99%

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Biphasic and monophasic repair: comparative implications for biologically equivalent dose calculations in pulsed dose rate brachytherapy of cervical carcinoma

Millar

Hendry²,

Davidson³

2013

BJR

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Objective: To consider the implications of the use of biphasic rather than monophasic repair in calculations of biologically-equivalent doses for pulsed-dose-rate brachytherapy of cervix carcinoma. Methods: Calculations are presented of pulsed-dose-rate (PDR) doses equivalent to former low-dose-rate (LDR) doses, using biphasic vs monophasic repair kinetics, both for cervical carcinoma and for the organ at risk (OAR), namely the rectum. The linear-quadratic modelling calculations included effects due to varying the dose per PDR cycle, the dose reduction factor for the OAR compared with Point A, the repair kinetics and the source strength. Results: When using the recommended 1 Gy per hourly PDR cycle, different LDR-equivalent PDR rectal doses were calculated depending on the choice of monophasic or biphasic repair kinetics pertaining to the rodent central nervous and skin systems. These differences virtually disappeared when the dose per hourly cycle was increased to 1.7 Gy. This made the LDR-equivalent PDR doses more robust and independent of the choice of repair kinetics and a/b ratios as a consequence of the described concept of extended equivalence. Conclusion:The use of biphasic and monophasic repair kinetics for optimised modelling of the effects on the OAR in PDR brachytherapy suggests that an optimised PDR protocol with the dose per hourly cycle nearest to 1.7 Gy could be used. Hence, the durations of the new PDR treatments would be similar to those of the former LDR treatments and not longer as currently prescribed. Advances in knowledge: Modelling calculations indicate that equivalent PDR protocols can be developed which are less dependent on the different a/b ratios and monophasic/biphasic kinetics usually attributed to normal and tumour tissues for treatment of cervical carcinoma.

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“…These PDR cycle numbers are consistent with those of 26 and 38 cycles (of exactly 1 Gy), respectively, calculated using the GEC-ESTRO recommendations [6].…”

Section: Discussionsupporting

confidence: 66%

“…by an average of 5.8% for these cervical treatments [6]. This implied a small therapeutic advantage of PDR vs LDR owing to lowering the average dose rate from around 1.5 to 1 Gy h 21 .…”

Section: Discussionmentioning

confidence: 99%

Section: Clinical Backgroundmentioning

confidence: 99%

mentioning

confidence: 99%

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Biphasic and monophasic repair: comparative implications for biologically equivalent dose calculations in pulsed dose rate brachytherapy of cervical carcinoma

Millar

Hendry²,

Davidson³

2013

BJR

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“…The choice of PDR over HDR was based on the theoretical radiobiological advantage of LDR (simulated by PDR treatment) treatments over those of higher dose rates (>12 Gy/hour) 3 . To deliver a tumoricidal brachytherapy dose at this dose rate would take on average 26–38 hours 4 and the decision was made to fractionate the treatment to improve patient comfort. While introducing a fractionated treatment comes with the obvious disadvantage of an extra anaesthesia and a corresponding increase in departmental workload, advantages are gained from allowing further optimisation of the second fraction (by applicator choice and dosimetric optimisation) to account for tumour shrinkage between fraction 1 and 2 of brachytherapy and gives rise to reduced uncertainties in organ at risk (OAR) positioning 4 …”

Section: Introductionmentioning

confidence: 99%

The implementation of a PDR 3D-guided gynaecological brachytherapy service in a UK centre

et al. 2013

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Background: Due to the discontinuation of the widely used low-dose rate (LDR) Caesium afterloader units, many centres in the past 10 years have moved from LDR Selectron treatments to Iridium 192 afterloaders. While the majority of UK centres have opted for high-dose rate (HDR) units, the Christie have invested in two pulsed dose rate (PDR) afterloaders alongside a move to full 3D-planned gynaecological brachytherapy.

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AAPM Task Group Report 267: A joint AAPM GEC‐ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy

Chen,

Li,

Brenner

et al. 2024

Medical Physics

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Brachytherapy utilizes a multitude of radioactive sources and treatment techniques that often exhibit widely different spatial and temporal dose delivery patterns. Biophysical models, capable of modeling the key interacting effects of dose delivery patterns with the underlying cellular processes of the irradiated tissues, can be a potentially useful tool for elucidating the radiobiological effects of complex brachytherapy dose delivery patterns and for comparing their relative clinical effectiveness. While the biophysical models have been used largely in research settings by experts, it has also been used increasingly by clinical medical physicists over the last two decades. A good understanding of the potentials and limitations of the biophysical models and their intended use is critically important in the widespread use of these models. To facilitate meaningful and consistent use of biophysical models in brachytherapy, Task Group 267 (TG‐267) was formed jointly with the American Association of Physics in Medicine (AAPM) and The Groupe Européen de Curiethérapie and the European Society for Radiotherapy & Oncology (GEC‐ESTRO) to review the existing biophysical models, model parameters, and their use in selected brachytherapy modalities and to develop practice guidelines for clinical medical physicists regarding the selection, use, and interpretation of biophysical models. The report provides an overview of the clinical background and the rationale for the development of biophysical models in radiation oncology and, particularly, in brachytherapy; a summary of the results of literature review of the existing biophysical models that have been used in brachytherapy; a focused discussion of the applications of relevant biophysical models for five selected brachytherapy modalities; and the task group recommendations on the use, reporting, and implementation of biophysical models for brachytherapy treatment planning and evaluation. The report concludes with discussions on the challenges and opportunities in using biophysical models for brachytherapy and with an outlook for future developments

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The Implementation of the Gynaecological Groupe Européen de Curiethérapie – European Society for Therapeutic Radiology and Oncology Radiobiology Considerations in the Conversion of Low Dose Rate to Pulsed Dose Rate Treatment Schedules for Gynaecological Brachytherapy

Cited by 3 publications

References 16 publications

Biphasic and monophasic repair: comparative implications for biologically equivalent dose calculations in pulsed dose rate brachytherapy of cervical carcinoma

Biphasic and monophasic repair: comparative implications for biologically equivalent dose calculations in pulsed dose rate brachytherapy of cervical carcinoma

The implementation of a PDR 3D-guided gynaecological brachytherapy service in a UK centre

AAPM Task Group Report 267: A joint AAPM GEC‐ESTRO report on biophysical models and tools for the planning and evaluation of brachytherapy

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