Impact of patient transfer system on applicator stability and dosimetry in cervical cancer brachytherapy.

IF 1.1 4区 医学 Q4 ONCOLOGY
Journal of Contemporary Brachytherapy Pub Date : 2025-06-01 Epub Date: 2025-06-30 DOI:10.5114/jcb.2025.152541
Jittima Junhong, Ekkasit Tharavichitkul, Anirut Watcharawipha, Somsak Wanwilairat, Wannapha Nobnop
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引用次数: 0

Abstract

Purpose: This study aimed to evaluate applicator displacement due to patient transfer using traditional fixation (TRD) with and without patient transfer system (TS), and to assess its dosimetric impact on organs at risk (OARs).

Material and methods: Computed tomography (CT) images, including high-risk clinical target volume (HR-CTV) and OARs structures, were analyzed from 46 treatment plans involving 32 patients undergoing intracavitary brachytherapy with tandem-ovoid applicator, using either traditional fixation (TRD) alone or in combination with patient transfer system (TRD + TS). Applicator displacement was assessed by measuring the distance between applicator base in two sets of CT images: one acquired during treatment planning (pre-plan), and second at dose delivery (pre-load). Dosimetric impact was evaluated for each simulated applicator shift.

Results: The use of TRD + TS resulted in reduced applicator displacement compared with TRD alone. The mean magnitude of displacement decreased from 2.94 mm to 1.43 mm laterally, from 3.17 mm to 1.83 mm in the anterior-posterior direction, and from 3.45 mm to 2.00 mm longitudinally. Regarding dose variations to D2cc for the bladder, rectum, sigmoid, and bowel, the average dose increases were 0.54%, 8.39%, 3.78%, and 0.58% for TRD, and 3.19%, 1.66%, 2.83%, and 1.19% for TRD + TS, respectively. No statistically significant difference was observed in either applicator displacement or radiation dose to OAR between the two systems.

Conclusions: The combination of traditional fixation and patient transfer system have the potential to reduce applicator displacement, thereby enhancing treatment accuracy. However, in this study, no statistically significant difference was observed when compared with our traditional fixation method.

Abstract Image

Abstract Image

Abstract Image

宫颈癌近距离放疗中患者转移系统对施药器稳定性和剂量测定的影响。
目的:本研究旨在评估使用传统固定(TRD)和不使用患者转移系统(TS)进行患者转移所导致的应用器位移,并评估其对危险器官(OARs)的剂量学影响。材料和方法:对32例使用卵圆贴合器进行腔内近距离放射治疗的46个治疗方案的CT图像进行分析,包括高危临床靶体积(HR-CTV)和OARs结构,这些治疗方案或单独使用传统固定(TRD)或联合患者转移系统(TRD + TS)。通过测量两组CT图像中涂抹器底座之间的距离来评估涂抹器位移:一组是在治疗计划期间获得的(预计划),另一组是在给药时获得的(预负荷)。评估每次模拟涂抹器移位的剂量学影响。结果:与单独使用TRD相比,使用TRD + TS可减少涂抹器位移。横向平均位移由2.94 mm减小到1.43 mm,前后方向由3.17 mm减小到1.83 mm,纵向由3.45 mm减小到2.00 mm。对于膀胱、直肠、乙状结肠和肠道的D2cc剂量变化,TRD组的平均剂量增加率分别为0.54%、8.39%、3.78%和0.58%,TRD + TS组的平均剂量增加率分别为3.19%、1.66%、2.83%和1.19%。两种系统在涂抹器位移或OAR辐射剂量方面没有统计学上的显著差异。结论:传统固定与患者转移系统的结合有可能减少应用器位移,从而提高治疗精度。然而,在本研究中,与我们的传统固定方法相比,没有观察到统计学上的显著差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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