Journal of Contemporary Brachytherapy最新文献

{"title":"A comparison of TG-43 and TG-186 dose calculation algorithms for treatment planning of intra-cavitary brachytherapy using tandem and ovoid applicator.","authors":"Syed Mohamed Shajid, Lalit Mohan Aggarwal, Ankur Mourya, Sunil Choudhary, Gogul Priean V, Ankita Singh, Saji Oommen","doi":"10.5114/jcb.2024.143138","DOIUrl":"10.5114/jcb.2024.143138","url":null,"abstract":"<p><strong>Purpose: </strong>The present study evaluated the dosimetric impact and compared the dose variations between the advanced collapsed cone engine (Task Group 186) and Task Group 43 plans for cervical cancer using tandem and ovoid applicators.</p><p><strong>Material and methods: </strong>Thirty cervical cancer patients underwent iridium-192 (¹⁹²Ir) high-dose-rate (HDR) intra-cavitary brachytherapy using tandem and ovoid applicator. Original treatment plans for all patients were created using TG-43 dose calculation formalism. Subsequently, these plans were re-calculated using ACE (TG-186) algorithm and were not re-optimized, so that dwell time and dwell positions were identical in both plans. High-risk clinical target volume and organs at risk were contoured in each dataset. Significant air gaps within region of interest and use of high density applicator materials were also considered. The assessment encompassed a point-based evaluation, extraction of dosimetric parameters from dose-volume histogram (DVH), and plan evaluation indices for each algorithm.</p><p><strong>Results: </strong>Compared with ACE (TG-186) plans, TG-43 plans predicted higher doses for point A, point B, D₉₀, D₁₀₀, V₁₀₀, V₁₅₀, V₂₀₀, and V₃₀₀ for HR-CTV (<i>p</i> < 0.05). Similarly, TG-43 plans indicated higher doses for bladder point, rectum point, D_0.1cm ³, D_10cm ³, and D_2cm ³ for bladder, rectum, and sigmoid (<i>p</i> < 0.05). Additionally, overall plan quality score (PQS) was significantly greater in plans calculated with ACE (TG-186) formalism than in TG-43 plans (<i>p</i> < 0.05). In TG-186 (ACE) plans, gradient index (GI) was found to be lower than that in TG-43 plans (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>TG-43 tends to overestimate doses compared with ACE (TG-186); nonetheless, both methods meet clinical standards. Material differences in the applicator are notable, and dose overestimations by TG-43 are within 5%.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 4","pages":"289-296"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric comparison of Acuros^TM BV and AAPM TG-43 formalism for interstitial iridium-192 high-dose-rate brachytherapy.","authors":"Yiannis Roussakis, Georgios Antorkas, Leonidas Georgiou, Iosif Strouthos, Efstratios Karagiannis, Constantinos Zamboglou, Konstantinos Ferentinos, Nikolaos Zamboglou, Georgios Anagnostopoulos","doi":"10.5114/jcb.2024.140893","DOIUrl":"10.5114/jcb.2024.140893","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was a retrospective dosimetric comparison of iridium-192 (¹⁹²Ir) high-dose-rate (HDR) interstitial brachytherapy plans using model-based dose calculation algorithm (MBDCA) following TG-186 recommendations and TG-43 dosimetry protocol for breast, head-and-neck, and lung patient cohorts, with various treatment concepts and prescriptions.</p><p><strong>Material and methods: </strong>In this study, 59 interstitial ¹⁹²Ir HDR brachytherapy cases treated in our center (22 breast, 22 head and neck, and 15 lung) were retrospectively selected and re-calculated with TG-43 dosimetry protocol as well as with Acuros^TM BV dose calculation algorithm, with dose to medium option based on computed tomography images. Treatment planning dose volume parameter differences were determined and their significance was assessed.</p><p><strong>Results: </strong>For the breast planning target volume (PTV), TG-43 formalism calculated higher D_90%, V_95%, V_100%, and V_150% values than Acuros^TM BV, ranging from 2.2% to 5.4% (mean differences), as it did for the head and neck cases, ranging from 2.5% to 4.7% and for the interstitial lung cases, ranging from 2.2% to 4.4%, showing statistical significance (<i>p</i> < 0.001). For the skin D_0.1cm3, D_0.2cm3, and D_1cm3, the values were overestimated by TG-43, with a mean absolute differences of 1.4, 1.8, and 2.0 Gy, respectively for the breast, and 1.0 Gy for all DVH statistics for the head and neck cases compared with Acuros^TM BV (<i>p</i> < 0.001). Ipsilateral lung V_5Gy was also higher in TG-43-calculated plans, with a mean difference of 1.0% and 1.1% in the breast and lung implants, respectively. For the chest wall TG-43, the respective overestimation in D_0.1cm3 and D_1cm3 was 0.8 and 0.8 Gy for the breast, and 0.4 and 0.3 Gy for the interstitial lung cases, respectively.</p><p><strong>Conclusions: </strong>The TG-43 algorithm significantly overestimates the dose to PTVs and surrounding organs at risk (OARs) for breast, head and neck, and lung interstitial implants. TG-43 overestimation is in accordance with previous findings for breast and head and neck. To our knowledge, this is also exhibited for Acuros^TM BV for the first time in interstitial lung HDR brachytherapy.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"211-218"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI-guided brachytherapy for cervical cancer treatment: The significance of bladder morphology in dose distribution planning.","authors":"Euncheol Choi, Byungyong Kim, Sang Jun Byun, Jin Hee Kim, Seung Gyu Park, Myeongsoo Kim","doi":"10.5114/jcb.2024.140931","DOIUrl":"10.5114/jcb.2024.140931","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective study aimed to investigate the influence of bladder filling type (BFT) on the relationship between bladder volume (BV) and maximum absorbed dose (D_2cc) in intra-cavitary brachytherapy (ICBT) for cervical cancer.</p><p><strong>Material and methods: </strong>The study enrolled 269 patients who underwent 3D-optimized ICBT guided by MRI scans between 2016 and 2022. Bladder shape (categorized as tilted, curved, or E) was determined based on specific applicators used. D_2cc values were recorded for critical organs, such as bladder, rectum, sigmoid colon, and small bowel.</p><p><strong>Results: </strong>The tilted group exhibited lower D_2cc values for the small bowel when BV was less than 400 cc, while still ensuring minimal doses to the rectum and sigmoid colon. In the curved group (BV ≤ 100 cc), significant variations in D_2cc for organs at risk were observed. However, in the E group, no substantial correlation between BV and D_2cc was identified (<i>p</i> = -0.035). Additionally, the mean mid-sagittal line differences in the tilted group were 8.47 mm (pre-ICBT) and 7.11 mm (during ICBT simulation), surpassing measurements in the other two groups.</p><p><strong>Conclusions: </strong>This study underscores the substantial impact of bladder shape on both the optimal bladder filling volume and maximum absorbed dose in cervical cancer ICBT. The implementation of BFT based on pre-ICBT MRI scans is both practical and beneficial. It accentuates the necessity of accounting for bladder shape when determining appropriate bladder filling volume, thus facilitating effective management of bladder and small bowel doses. Further prospective studies are warranted to assess the effect of BFT on the incidence of cystitis and proctitis following ICBT, all while maintaining consistent bladder distension.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"184-192"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-treatment T2-weighted magnetic resonance radiomics for prediction of loco-regional recurrence after image-guided adaptive brachytherapy for locally advanced cervical cancer.","authors":"Pittaya Dankulchai, Natthakorn Thanamitsomboon, Wiwatchai Sittiwong, Nont Kosaisawe, Kullathorn Thephamongkhol, Wisawa Phongprapun, Tissana Prasartseree","doi":"10.5114/jcb.2024.141458","DOIUrl":"10.5114/jcb.2024.141458","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to investigate the predictive value of radiomic features of pre-treatment T2-weighted magnetic resonance images (MRI) for clinical outcomes of radiotherapy in cervical cancer patients.</p><p><strong>Material and methods: </strong>Ninety cervical cancer patients with stage IB-IVA were retrospectively analyzed. All patients received definitive radiotherapy with or without concurrent chemotherapy. Radiomic features were extracted from gross tumor volume (GTV) on pre-treatment T2-weighted MRI. The association between radiomic features and loco-regional recurrence (LRR) was analyzed with Student's <i>t</i> test, and false discovery rate was controlled using Storey method. Multivariate analysis with significant radiomic features with <i>p</i>-value < 0.01 and known clinical prognostic factors was performed using Cox proportional hazard model.</p><p><strong>Results: </strong>The majority of patients were stage IIIB (47.8%) and stage IIB (36.7%), and the most common histology was squamous cell carcinoma (74.5%). The median GTV volume was 37.5 ml (IQR, 16.3-93.1). The median dose of D₉₀ received by high-risk clinical target volume (HR-CTV) was 86.2 Gy (IQR, 67.2-94.2). In a median follow-up time of 29.2 months, 12 of the 90 patients (13.3%) developed LRR. Eighty radiomic features were collected. There were four radiomic features, which showed significant correlation with LRR: Maximum intensity (<i>p</i> = 0.0002), Correlation135 GLCM (<i>p</i> = 0.0014), Correlation90 (<i>p</i> = 0.0015), and Correlation45 (<i>p</i> = 0.0034). Cox regression analysis yielded a significant hazard ratio for the maximum intensity (<i>p</i> = 0.038) and Correlation135 GLCM (<i>p</i> = 0.013) features. There was no statistically significant association for overall survival with any radiomic features.</p><p><strong>Conclusions: </strong>The maximum intensity and Correlation135 GLCM radiomic features of the pre-treatment T2-weighted MR images are predictive of loco-regional recurrence in cervical cancer patients after definitive radiotherapy with 3D-IGABT.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"193-201"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-effect relationship in external beam radiotherapy combined with brachytherapy for cervical cancer: A systematic review.","authors":"Ning Wu, Mingwei Bu, Hairong Jiang, Xin Mu, Hongfu Zhao","doi":"10.5114/jcb.2024.140760","DOIUrl":"10.5114/jcb.2024.140760","url":null,"abstract":"<p><strong>Purpose: </strong>External beam radiotherapy with concurrent chemotherapy combined with brachytherapy has been described as the first treatment choice for locally advanced cervical cancer. This study aimed to systematically review the dose-effect relationship (DER) of target volumes and organs at risk (OARs) in external beam radiotherapy combined with brachytherapy for cervical cancer.</p><p><strong>Material and methods: </strong>Studies reporting DER in radical radiotherapy for cervical cancer were determined by searching PubMed, Web of Science, and Cochrane Library databases till Jan 20, 2023. Dose parameters of DER, end-point of tumor control or type and grade of side effects of OARs as well as prediction results were analyzed from included studies. Coordinates of DER curves from the included studies were extracted and DER curves were reconstructed in the same coordinate system for comparison.</p><p><strong>Results: </strong>Thirty studies, including eleven dose-response relationships for clinical end-points, and nineteen dose-toxicity relationships for OARs were evaluated in systematic review. The most common dose-response relationship between the same dose parameter and the same clinical end-point was HR-CTV D₉₀ vs. local tumor control, while it was D_2cc of rectum versus rectal grade 2-4 side effects for dose-toxicity relationship.</p><p><strong>Conclusions: </strong>In the radical radiotherapy of cervical cancer, there were significant DERs for target volumes and OARs. Considering the interference of these factors, DERs in sub-group patients would provide precise and individualized dose constraints of radiotherapy for cervical cancer in the future.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"232-240"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolving landscape of head and neck brachytherapy: A scoping review.","authors":"Marjorie Mae Cua, Carl Jay Jainar, Janella Ann Javenrie Calapit, Michael Benedict Mejia, Warren Bacorro","doi":"10.5114/jcb.2024.140348","DOIUrl":"10.5114/jcb.2024.140348","url":null,"abstract":"<p><strong>Purpose: </strong>Since the last update of GEC-ESTRO (Groupe Européen de Curiethérapie - European Society for Therapeutic Radiology and Oncology) recommendations for head and neck (HN) brachytherapy in 2017, advances in understanding and management of HN cancers have influenced brachytherapy. We conducted a scoping review to depict the evolution of HN brachytherapy research and practice, and identify emerging topics since the previously published guidelines.</p><p><strong>Material and methods: </strong>Systematic literature search was performed in PubMed, EBSCOhost, Europe PMC, and Google Scholar databases for articles on HN brachytherapy from 2017 onwards; the search was last done on June 29, 2023. We included primary studies on HN brachytherapy in English, complemented by bibliography scanning of secondary studies. Iterative team approach was employed in data extraction and charting. Quantitative and qualitative analyses and narrative synthesis were performed.</p><p><strong>Results: </strong>Systematic search yielded 215 unique articles. A total of 132 primary studies were included: 112 on clinical outcomes (retrospective cohorts in majority, <i>n</i> = 72), and 22 were simulation and dosimetric studies. China consistently produced the most research output per year. The most studied sites were the oral cavity (<i>n</i> = 84), oropharynx (<i>n</i> = 37), and salivary glands (<i>n</i> = 20). While most reported on high-dose-rate brachytherapy (<i>n</i> = 57), there was resurgence of studies on low-dose-rate (LDR) brachytherapy (<i>n</i> = 50) in the form of permanent seed implants. In the latter, CT (<i>n</i> = 50) and template (<i>n</i> = 27) guidance were described. While majority discussed definitive brachytherapy, 18 reported on perioperative brachytherapy. Several reported on 3D printing for template and applicator design (<i>n</i> = 11) as well as new approaches to dose calculation or dose optimization algorithms (<i>n</i> = 2).</p><p><strong>Conclusions: </strong>The current scoping review identified recent trends in HN brachytherapy, such as application in other HN sites, use of LDR seed implants, perioperative brachytherapy, and 3D printing in template design. Data from these recent publications provide a foundation for further investigations, which can generate evidence for succeeding guidelines.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"225-231"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individualized 3D printing for skin cancer brachytherapy: Development, implementation, clinical applications, and treatment assessment.","authors":"Michal Poltorak, Pawel Banatkiewicz, Lukasz Poltorak, Piotr Sobolewski, Damian Zimon, Maciej Szwast, Irena Walecka","doi":"10.5114/jcb.2024.141420","DOIUrl":"10.5114/jcb.2024.141420","url":null,"abstract":"<p><strong>Purpose: </strong>This study outlined the prevalent use of brachytherapy in skin cancers, such as basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). The importance of customized applicator fabrication for optimal treatment delivery was highlighted, focusing on adaptable devices tailored to individual patient anatomy, often facilitated by 3D printing technology. The purpose of this work was to investigate the association of medical science and 3D printing in customized applicator fabrication for brachytherapy, leveraging the advancements in fabrication techniques to enhance treatment precision and patient outcomes.</p><p><strong>Material and methods: </strong>The study enrolled five patients with tumor lesions unsuitable for surgical intervention, situated across various anatomical locations, such as earlobe, temple, hand, and cheek. Customized applicators were fabricated <i>via</i> 3D printing (fused deposition modeling) for each patient, followed by radiotherapy protocol delivering a total dose of 51 Gy in 17 fractions. Patient assessments during and post-radiotherapy were done by radiation oncologist using RTOG scale as well as dermatological evaluations with dermatoscopy and reflectance confocal microscopy. Methodologically, applicators were 3D-printed using fused deposition modeling technology. Printing parameters were optimized in Prusa Slicer software, ensuring precise control in printout shape correlated with treatment efficacy.</p><p><strong>Results: </strong>This study examined the therapeutic outcomes of brachytherapy in five patients with inoperable skin cancer lesions. Utilizing customized 3D-printed applicators, the patients underwent brachytherapy regimen delivering a cumulative dose of 51 Gy in 17 fractions. The evaluation with RTOG scale revealed varied treatment responses, with complete remission achieved in all cases. Reflectance confocal microscopy showed post-treatment normalization of epidermal morphology and notable scar formation. Optical profilometry demonstrated consistent micro-structures on the applicator surfaces, without compromising treatment efficacy. These findings indicated the potential of 3D-printed applicators in optimizing brachytherapy outcomes in skin cancer management.</p><p><strong>Conclusions: </strong>Our study demonstrates the effectiveness of 3D-printed applicators in treating inoperable skin cancer lesions with high precision. In personalized fabrication, optimal conformity with anatomical features was achieved, resulting in complete remission in all patients. This approach minimizes treatment-related side effects and enhances overall patient outcomes, suggesting a promising future for 3D printing technology in skin cancer treatment applications. Further research and clinical validation are needed to establish 3D printing as a standard practice in skin cancer treatment.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"173-183"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor-in-Chief regarding \"Adjuvant pulse-dose-rate brachytherapy for oral cavity and oropharynx carcinoma: Outcome and toxicity assessment of 66 patients\".","authors":"Erkan Topkan, Efsun Somay, Ugur Selek","doi":"10.5114/jcb.2024.141188","DOIUrl":"10.5114/jcb.2024.141188","url":null,"abstract":"","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"171-172"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric comparison between single-channel vaginal cylinder and free-hand interstitial needles in vaginal brachytherapy of gynecological cancers.","authors":"Kaiqiang Chen, Yanhong Zhuo, Zirong Li, Penggang Bai, Jihong Chen, Yibin Lin, Jing Liu, Li Li, Yang Yang, Junping Pan, Yanwen Song, Tianming Wu, Xiuchun Zhang, Qin Xu","doi":"10.5114/jcb.2024.141169","DOIUrl":"10.5114/jcb.2024.141169","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the dosimetric differences in vaginal brachytherapy (VBT) using single-channel vaginal cylinder (SCVC) and free-hand interstitial needles (FIN).</p><p><strong>Material and methods: </strong>Twenty-two women with malignant gynecologic tumors were prospectively treated with image-guided high-dose-rate (HDR) brachytherapy after surgery and external beam radiation therapy (EBRT). All HDR treatments were delivered using FIN implant technique. For dosimetric comparison purposes only, SCVCs of 2.5 cm diameter were placed in all patients. No sources were dwelled in cylinder applicator during clinical treatment. CT-guided brachytherapy treatment planning was performed according to GEC-ESTRO guidelines, with high-risk clinical target volume (HR-CTV) delineated based on clinical exams and MRI T2 sequences. Dose-volume parameters to HR-CTV and surrounding organs at risk (OARs) from interstitial plans were compared with those achieved from cylinder plans.</p><p><strong>Results: </strong>Compared with SCVC group, FIN group showed the same HR-CTV coverage. FIN group had higher V_150% and V_200% (<i>p</i> < 0.05). In addition, it had lower HI (<i>p</i> < 0.05). However, doses to the rectum D_0.1cc (538.5 ±119.8 cGy), D_1cc (415.4 ±73.3 cGy), D_2cc (355.7 ±66.6 cGy), and D_mean (162.8 ±43.7 cGy) as well as the bladder D_0.1cc (516.1 ±85.2 cGy) and D_1cc (392.9 ±59.8 cGy) were lower in FIN group than in SCVC group (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>FIN technique can be a dosimetrically preferable alternative to the commonly used SCVC for HDR VBT boost in patients with gynecological malignancies. It provides adequate coverage of target volumes, with minimal radiation dose to surrounding organs at risk.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"219-224"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of vaginal toxicities following definitive chemoradiation in intact cervical cancer: A meta-analysis.","authors":"Shraddha Raj, Rajiv Ranjan Prasad, Alok Ranjan","doi":"10.5114/jcb.2024.141402","DOIUrl":"10.5114/jcb.2024.141402","url":null,"abstract":"<p><strong>Purpose: </strong>Cervical cancer is a significant global health burden, with advancements in treatment modalities improving outcomes. However, vaginal toxicities following definitive chemoradiation remain a concern, impacting patients' quality of life. The aim of this systematic review and meta-analysis was to estimate the incidence of vaginal toxicities, explore associated factors, and assess the relationship with radiation dose in intact cervical cancer patients undergoing radical chemoradiation.</p><p><strong>Material and methods: </strong>A systematic search of PubMed, Google Scholar, and Cochrane databases was conducted. Studies reporting on vaginal toxicities post-radical chemoradiation in intact cervical cancer patients were included. Data extraction and analysis were performed according to PRISMA guidelines.</p><p><strong>Results: </strong>Twenty-four studies with various designs were included. The meta-analysis revealed a pooled estimate of 39% (95% CI: 21-56%) for overall vaginal toxicities among cervical cancer patients following definitive chemoradiation. Vaginal stenosis was the most commonly reported toxicity, with a median incidence of 61.5% (range, 20-77.8%) across the studies. Severe toxicities (grade ≥ 3) were reported at rates of 12.74% (CTCAE v. 4.0), 0.98% (CTCAE v. 3.0), 10.41% (RTOG/EORTC), and 0% (LENT-SOMA). Factors, such as age, initial vaginal involvement, and radiation dose were associated with increased toxicity risk. Significant heterogeneity was observed in study populations and methodologies.</p><p><strong>Conclusions: </strong>Vaginal toxicities are common following definitive chemoradiation in intact cervical cancer patients, with vaginal stenosis being predominant. Standardization of toxicity scoring methods and radiotherapy dose reporting parameters is crucial for accurate comparison and interpretation of findings. Future research should focus on optimizing treatment strategies to minimize vaginal toxicities while maximizing efficacy and patient outcomes.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"16 3","pages":"241-256"},"PeriodicalIF":1.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11609866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}