Influence of dwell time homogeneity error weight parameter on treatment plan quality in inverse optimized high-dose-rate cervix brachytherapy using SagiPlan.
This study, for the first time, aims to quantify the impact of modulation restriction on plan quality indices in inverse optimization for cervix high-dose-rate (HDR) brachytherapy using the BEBIG SagiPlan treatment planning system. Material and methods: Ten cervical cancer patient plans were optimized for treatment with a BEBIG SagiNova 60Co HDR afterloader using the min/max inverse planning method, with dwell time homogeneity error weight (DTHEW) parameter values of 0 to 10. Dwell time homogeneity and gradients as well as various plan quality indices were analyzed. Results: For DTHEW = 0, min/max-based optimization yielded higher HR-CTV D90 values than the variance-based option (p 1, an increase of this parameter did not always result in more homogeneous dwell times or reduced gradients in individual patients. There was a negative correlation between DTHEW and both HR-CTV D90 and V100 (p
CONCLUSIONS: The first results of treatment with the Axxent eBT device are promising, as no recurrences have been observed and toxicity is very low. eBT is a good alternative for treating cervical cancer in centers without access to conventional HDR. PMID: 31183970 [PubMed - as supplied by publisher]
Conclusions: A combination of MRI and CT is a safe alternative approach for cervical cancer HDR brachytherapy. The technique provides comparable dosimetric outcomes to MRI-based planning, while being more cost-effective. PMID: 30479618 [PubMed]
Conclusions: Fletcher applicator generates higher dose to both CTV and organs at risk (2 cc volumes) after all optimization techniques. Dose restriction to rectum is possible using graphical optimization only during selected HDR fractionation schedules. Bladder always receives dose higher than recommended, and 2 cc sigmoid colon always gets permissible dose. Contrarily, graphical optimization with ring applicators fulfills all dose volume objectives in all HDR fractionations practiced. PMID: 29204164 [PubMed]
CONCLUSIONS: POGS reduced treatment plan optimization time approximately 18 times for RSBT with similar HR-CTV D90, organ at risk (OAR) D2cc values, and EQD2 values compared to CPLEX, which is significant progress toward clinical translation of RSBT. This article is protected by copyright. All rights reserved. PMID: 28744870 [PubMed - as supplied by publisher]
CONCLUSIONS: Hydrogel instillation is a useful tool for recto-vaginal separation during cervical cancer brachytherapy. It increases therapeutic ratio without any adverse event. PMID: 27895681 [PubMed - in process]
Image guided brachytherapy (IGBT) in carcinoma cervix has shown dosimetric as well as clinical advantage over point based brachytherapy. Typically, dose constraints are given to urinary bladder, rectum and sigmoid colon during IGBT as per the Groupe Européen de Curiethérapie-European Society of Therapeutic Radiation Oncology (GEC-ESTRO) guidelines. Although radiation also causes vaginal toxicity, vagina as an organ at risk has not been defined and the dose volume relationship with toxicity remains unknown.
CONCLUSIONS: H-RSBT is a mechanically feasible delivery technique for use in the curved applicators needed for cervical cancer brachytherapy. S-RSBT and H-RSBT were clinically equivalent for all patients considered, with the H-RSBT technique tending to require less time for delivery. PMID: 26520749 [PubMed - in process]
CONCLUSIONS: P-RSBT produces treatment plans that are dosimetrically and temporally superior to those of S-RSBT and D-RSBT, although P-RSBT systems may be more mechanically challenging to develop than S-RSBT or D-RSBT. A P-RSBT implementation with 4-6 shield paddles would be sufficient to outperform S-RSBT and D-RSBT if delivery times are constrained to less than 15 min/fx. PMID: 26429274 [PubMed - in process]
High dose rate (HDR) intracavitary brachytherapy has become common practice in the treatment and management of cervical cancer. During HDR brachytherapy of the cervix, the main organs at risk (OAR) for radiation exposure are the bladder, rectum, sigmoid colon and small bowel. Irradiation of these organs can lead to a number of late complications following radiation therapy. For a treatment plan to be exceptionally effective, it requires both deliverance of desired prescription dose to the target organ but also a minimization of dose distribution to the OAR.
Abstract BACKGROUND AND PURPOSE: To report on normal tissues morbidity following IMRT for cervix cancer. MATERIAL AND METHODS: The first 61 patients of a prospective series were included. 50Gy to the PTV 1(pelvis) and 60Gy to the PTV 2 (centro-pelvic disease and GTV nodes) were delivered concomitantly in 28 fractions, followed by a brachytherapy boost. For the small bowel, 50Gy was the maximal dose, while V45 and V40 had to be