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Dosimetric evaluation of tandem-based cervical high-dose-rate brachytherapy treatment planning using American Brachytherapy Society 2011 recommendations

Published online by Cambridge University Press:  15 April 2016

Manish K. Goyal ,
T. S. Kehwar ,
Jayanand Manjhi ,
Jerry L. Barker ,
Bret H. Heintz ,
Kathleen L. Shide  and
D. V. Rai
Manish K. Goyal
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA Department of Biomedical Engineering, Shobhit University, Meerut, India
T. S. Kehwar*
Affiliation:
Department of Radiation Oncology, Pinnacle Health Cancer Center, Harrisburg, PA, USA
Jayanand Manjhi
Affiliation:
Department of Biomedical Engineering, Shobhit University, Meerut, India
Jerry L. Barker
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
Bret H. Heintz
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
Kathleen L. Shide
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
D. V. Rai
Affiliation:
Department of Biomedical Engineering, Shobhit University, Meerut, India
*
Correspondence to: T. S. Kehwar, Department of Radiation Oncology, Pinnacle Health Cancer Center, Harrisburg, PA 17109, USA. Tel: 001 717 724 6734. E-mail: [email protected]
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Abstract

Purpose

This study evaluated dosimetric parameters for cervical high-dose-rate (HDR) brachytherapy treatment using varying dose prescription methods.

Methods

This study includes 125 tandem-based cervical HDR brachytherapy treatment plans of 25 patients who received HDR brachytherapy. Delineation of high-risk clinical target volumes (HR-CTVs) and organ at risk were done on original computed tomographic images. The dose prescription point was defined as per International Commission in Radiation Units and Measurements Report Number 38 (ICRU-38), also redefined using American Brachytherapy Society (ABS) 2011 criteria. The coverage index (V100) for each HR-CTV was calculated using dose volume histogram parameters. A plot between HR-CTV and V100 was plotted using the best-fit linear regression line (least-square fit analysis).

Results

Mean prescribed dose to ICRU-38 Point A was 590·47±28·65 cGy, and to ABS Point A was 593·35±30·42 cGy. There was no statistically significant difference between planned ICRU-38 and calculated ABS Point A doses (p=0·23). The plot between HR-CTV and V100 is well defined by the best-fit linear regression line with a correlation coefficient of 0·9519.

Conclusion

For cervical HDR brachytherapy, dose prescription to an arbitrarily defined point (e.g., Point A) does not provide consistent coverage of HR-CTV. The difference in coverage between two dose prescription approaches increases with increasing CTV. Our ongoing work evaluates the dosimetric consequences of volumetric dose prescription approaches for these patients.

Keywords

American Brachytherapy Societycervical cancerhigh-dose-rate brachytherapyintracavitary brachytherapyPoint A
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 3 , September 2016 , pp. 283 - 289
Copyright
© Cambridge University Press 2016 

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References

1. American Cancer Society. Cancer facts & figures 2015. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-044552.pdf.Google Scholar
2. Klopp, A, Eifel, P. Chemoradiotherapy for cervical cancer in 2010. Curr Oncol Rep 2011; 13: 77–85.Google Scholar
3. Stewart, A J, Viswanathan, A N. Current controversies in high-dose-rate versus low-dose-rate brachytherapy for cervical cancer. Cancer 2006; 107: 908–915.Google Scholar
4. Patel, F D, Sharma, S C, Negi, P S et al. Low dose rate vs. high dose rate brachytherapy in the treatment of carcinoma of the uterine cervix: a clinical trial. Int J Radiat Oncol Biol Phys 1994; 28: 335–341.Google Scholar
5. Tod, M, Meredith, W. A dosage system for use in the treatment of cancer of the uterine cervix. Br J Radiol 1938; 11: 809–824.Google Scholar
6. Tod, M, Meredith, W. Treatment of cancer of the cervix uteri, a revised ‘Manchester method’. Br J Radiol 1953; 26: 252–257.Google Scholar
7. International Commission on Radiation Units and Measurements. ICRU report 38. Bethesda, MD: International Commission on Radiation Units and Measurements, 1985: 1–20.Google Scholar
8. Viswanathan, A N, Erickson, B A. Three-dimensional imaging in gynecologic brachytherapy: a survey of the American Brachytherapy Society. Int J Radiat Oncol Biol Phys 2010; 76: 104–109.Google Scholar
9. Kirisits, C, Potter, R, Lang, S et al. Dose and volume parameters for MRI-based treatment planning in intracavitary brachytherapy for cervical cancer. Int J Radiat Oncol Biol Phys 2005; 62: 901–911.Google Scholar
10. Potter, R, Haie-Meder, C, Van Limbergen, E et al. Recommendations from gynaecological (GYN) GEC ESTRO Working Group (I): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV. Radiother Oncol 2005; 74: 235–245.Google Scholar
11. Potter, R, Haie-Meder, C, Van Limbergen, E et al. Recommendations from gynaecological (GYN) GEC ESTRO Working Group (II): concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiother Oncol 2006; 78: 67–77.Google Scholar
12. Nag, S, Erickson, B, Thomadsen, B et al. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys 2000; 48: 201–211.Google Scholar
13. Viswanathan, A N, Thomadsen, B. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part I: general principles. Brachytherapy 2012; 11: 33–46.Google Scholar
14. Viswanathan, A N, Beriwal, S, Santos, J F D L et al. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part II: high dose rate brachytherapy. Brachytherapy 2012; 11: 47–52.Google Scholar
15. Anderson, J, Huang, Y, Kim, Y. Dosimetric impact of point A definition on high-dose-rate brachytherapy for cervical cancer: evaluations on conventional point A and MRI-guided, conformal plan. J Contemp Brachytherapy 2012; 4 (4): 241–246.Google Scholar
16. Lindegaard, J C, Potter, R, Limbergen, E V et al Clinical aspects of treatment planning (Chapter 10). In: Viswanathan A N et al. (eds). Gynecologic Radiation Therapy, 126.Google Scholar
17. Lindegaard, J C, Tanderup, K, Nielsen, S K, Haack, S, Gelineck, J. MRI guided 3D optimization significantly improves DVH parameters of pulsed dose rate brachytherapy in locally advanced cervical cancer. Int J Radiat Oncol Biol Phys 2008; 71 (3): 756–764.Google Scholar
18. Hashim, N, Jamalludin, Z, Ung, N M et al. CT based 3-dimensional treatment planning of intracavitary brachytherapy of cancer of the cervix: comparison between dose-volume histograms and ICRU point doses to the rectum and bladder. Asian Pac J Cancer Prev 2014; 15 (13): 5259–5264.Google Scholar