Journal of Contemporary Brachytherapy最新文献

{"title":"Dosimetric impact of applying a model-based dose calculation algorithm for skin cancer brachytherapy (interventional radiotherapy)","authors":"Elisa Placidi, Bruno Fionda, Enrico Rosa, Valentina Lancellotta, Antonio Napolitano, Martina De Angeli, Francesco Pastore, Maria Antonietta Gambacorta, Luca Indovina, Luca Tagliaferri, Marco De Spirito","doi":"10.5114/jcb.2023.134173","DOIUrl":"https://doi.org/10.5114/jcb.2023.134173","url":null,"abstract":"<b>Purpose:</b><br/>Brachytherapy (BT, interventional radiotherapy) is a well-established radiotherapy technique capable of delivering high doses to tumors while sparing organs at risk (OARs). Currently, the clinically accepted dose calculation algorithm used is TG-43. In the TG-186 report, new model-based dose calculation algorithms (MBDCA), such as Elekta’s advanced collapsed cone engine (ACE), have been introduced, although their clinical application is yet to be fully realized. This study aimed to investigate two aspects of TG-186: firstly, a comparison of dose distributions calculated with TG-43 and TG-186 for skin tumors; and secondly, an exploration of the impact of using a water bolus on the coverage of clinical target volume (CTV) and OARs.<br/><br/><b>Material and methods:</b><br/>Ten treatment plans for high-dose-rate IRT were developed. All plans were initially calculated using the TG-43 algorithm, and were subsequently re-calculated with TG-186. In addition, one of the treatment plans was assessed with both TG-43 and TG-186, using 10 different water bolus thicknesses ranging from 0 to 5 cm. To assess dose variations, the following dose-volume histogram (DVH) parameters were compared: D_2cc and D_0.01cc for OARs, and V₁₅₀, V₁₀₀, V₉₅ and V₉₀ for CTV coverage.<br/><br/><b>Results and conclusions:</b><br/>The average dosimetric results for CTV and OARs, as calculated by both algorithms, revealed statistically significant lower values for TG-186 when compared with TG-43. The presence of a bolus was observed to enhance CTV coverage for the TG-186 algorithm, with a bolus thickness of 2 cm being the point at which ACE calculations matched those of TG-43. This study identified significant differences in dosimetric parameters for skin tumors when comparing the TG-43 and TG-186 algorithms. Moreover, it was demonstrated that the inclusion of a water bolus increased CTV coverage in TG-186 calculations.<br/><br/>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"96 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139412085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Montreal split ring applicator: Towards highly adaptive gynecological brachytherapy using 3D-printed biocompatible patient-specific interstitial caps","authors":"Yuji Kamio, Marie-Ève Roy, Lori-Anne Morgan, Maroie Barkati, Marie-Claude Beauchemin, François DeBlois, Borko Basaric, Jean-François Carrier, Stéphane Bedwani","doi":"10.5114/jcb.2023.133676","DOIUrl":"https://doi.org/10.5114/jcb.2023.133676","url":null,"abstract":"<b>Purpose:</b><br/>The addition of interstitial (IS) needles to intra-cavitary (IC) brachytherapy applicators is associated with improved outcomes in locally advanced cervical cancers involving parametrial tumor extensions. The purpose of this work was to validate a clinical workflow involving 3D-printed caps for a commercial IC split ring applicator that enable using IS needle trajectories tailored to each treatment.<br/><br/><b>Material and methods:</b><br/>A dedicated software module was developed in this work allowing users to design patient-specific IS caps without knowledge of computer-aided design (CAD) software. This software module was integrated to 3D Brachy, a commercial software developed by Adaptiiv Medical Technologies Inc. For validation of the workflow, CAD models of ground truth caps with five IS needle trajectories were designed with Fusion 360™, 3D-printed, assembled with a split ring applicator, and CT-scanned with radio-opaque markers. 3D Brachy was then applied to generate a replica based on trajectories reconstructed from the radio-opaque markers. A comparison between ground truth and replicated IS needle trajectories was done using intersection points with planes at the level of the cervix (z = 0 cm) and a representative needle depth (z = 3 cm).<br/><br/><b>Results:</b><br/>Prototypes of interstitial caps 3D-printed in both BioMed Amber and BioMed Clear SLA resins were tested to be functional both pre- and post-sterilization for IS needles with obliquity angles ≤ 45°. Distance-to-agreement at z = 0 cm and 3 cm as well as deviations in pitch and yaw angles of the five IS needle trajectories were found to have mean values of 3.3 ±2.1 mm, 7.3 ±2.0 mm, 2.9° ±2.3°, and 7.0° ±7.0°, respectively.<br/><br/><b>Conclusions:</b><br/>The clinical workflow for image-guided adaptive cervical cancer brachytherapy using the Montreal split ring applicator was validated.<br/><br/>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"209 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139398604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the effect of eccentric ruthenium plaque placement on tumor volume dose","authors":"Jeremy P. M. Flanagan, William H. F. Udovenya, Melvin A. Astrahan, Daniel McKay, Claire Phillips, John D. McKenzie, Roderick O’Day, Lotte S. Fog","doi":"10.5114/jcb.2023.133614","DOIUrl":"https://doi.org/10.5114/jcb.2023.133614","url":null,"abstract":"<b>Purpose:</b><br/>Ruthenium-106 brachytherapy is a common treatment for small to medium-sized uveal melanomas. In certain clinical contexts, plaques may be placed eccentrically to tumor center. The effect of plaque decentration, a common radiation dose measurement in radiotherapy: D_98%, the percentage of the tumor volume receiving at least 98% of the prescribed dose (a commonly used term in radiation oncology), is unknown. We investigated this using two commonly used plaques (CCA and CCB; Eckert &amp; Ziegler, BEBIG GmbH) <i>in silico</i>.<br/><br/><b>Material and methods:</b><br/>Using a Plaque Simulator™ (Eye Physics) plaque modelling software, treatment time required to deliver 100 Gy D_98% with central plaque placement was calculated for both plaque models, treating tumors with basal dimensions of 10 mm (CCB plaque only) and 7 mm (CCA and CCB plaques), and a range of thicknesses. D_98% was calculated for plaque-tumor edge distances of 0-5 mm. Additionally, we defined minimum plaque-tumor edge distances, at which D_98% fell by 10% and 5% (safety margins).<br/><br/><b>Results:</b><br/>D_98% decreased as plaque-tumor edge distance decreased, i.e. as plaque eccentricity increased. Minor (&lt; 1 mm) plaque decentration caused minimal D_98% changes across tumor thicknesses. Safety margins did not follow a consistent pattern.<br/><br/><b>Conclusions:</b><br/>Eccentric plaque placement reduces the radiation dose delivered to choroidal tumors. Both tumor (thickness, diameter) and plaque (size, location) characteristics are important D_98% modulators. Further investigation of the effect of these characteristics and dose to organs at risk is essential.<br/><br/>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"31 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139398376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D-printed vaginal cylindrical template with curved needle channels in MRI-guided vaginal cuff brachytherapy","authors":"Zhuang Mao, Hongfu Zhao","doi":"10.5114/jcb.2023.133227","DOIUrl":"https://doi.org/10.5114/jcb.2023.133227","url":null,"abstract":"<b>Purpose:</b><br/>To present a new technique for the treatment of vaginal cuff recurrences using 3D-printed vaginal cylindrical template (3D-PVCT) with curved needle channels in brachytherapy.<br/><br/><b>Material and methods:</b><br/>Two patients with vaginal cuff tumor treated with external beam radiotherapy and MRI-guided interstitial brachytherapy were selected for the present study. Prior to treatment, a vaginal cylinder with the same size as 3D-PVCT was inserted into the vagina. Magnetic resonance scan was performed to identify target volumes and organs at risk (OARs). By registration techniques, the implantation angle was determined, appropriate needle channels were selected, and the depth of each needle position was recorded. During the actual treatment, patients were under general anesthesia, and real-time guidance of trans-rectal ultrasound was applied referring to a pre-determined treatment plan.<br/><br/><b>Results:</b><br/>For patient No. 1, 9 needles were inserted into the tumor, with 4 curved needle channels and 5 straight channels. For patient No. 2, 7 needles were inserted into the vaginal cuff tumor, with 6 curved needle channels and 1 straight channel. Doses delivered to volumes of targets and OARs for both patients met the EMBRACE II dose constraints. After follow-up of 15 and 18 months, respectively, both patients showed complete response, with no evidence of tumor recurrence. No significant acute or late toxicities were reported.<br/><br/><b>Conclusions:</b><br/>With careful pre-planning, 3D-PVCT provides good target coverage and sparing of OARs. The results from these two patients indicate that this approach is very promising due to its flexibility and potential widespread application in the future.<br/><br/>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"50 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139398544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simple fabrication technique of personalized endocavitary brachytherapy applicator for maxillary alveolar cancer","authors":"Warren Bacorro, Janell Marie Genson, Audri Joelle Dueñas, Henri Cartier Co, Antonio Villalon, Alfredo Pontejos","doi":"10.5114/jcb.2023.133069","DOIUrl":"https://doi.org/10.5114/jcb.2023.133069","url":null,"abstract":"<b>Purpose:</b><br/>We report on methods and outcomes of post-operative endocavitary brachytherapy after prior irradiation and salvage surgery in a patient with maxillary alveolar squamous cell carcinoma (SCC).<br/><br/><b>Material and methods:</b><br/>A 67-year-old male with right maxillary alveolar SCC was referred for brachytherapy after prior definitive chemoradiotherapy and salvage posterior maxillectomy. A personalized endocavitary applicator was fabricated using dental impression plastic tray, vinyl polysiloxane paste, and four flexible catheters to deliver fourteen 3.5 Gy high-dose-rate fractions. High-risk and intermediate-risk clinical target volumes were treated to 3.7 Gy (D₉₀) and 2.4 Gy (D₉₈), with mandibular dose limited to 2.3 Gy (D_2cc) per fraction. These corresponded to total 2 Gy equivalent doses (EQD₂) of 72.8 Gy, 40.5 Gy, and 34 Gy, respectively.<br/><br/><b>Results:</b><br/>The patient developed grade 2 mucositis and was disease-free for six months. He had biopsy-confirmed local recurrence at 8 months. He refused further treatment and expired within a month.<br/><br/><b>Conclusions:</b><br/>This simple approach to a personalized endocavitary applicator is feasible and allows for lower costs and less treatment delays, while ensuring patient comfort and convenience.<br/><br/>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"46 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139398442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric impact of applicator displacement on three-dimensional image-guided high-dose-rate brachytherapy treatments for cervical cancer.","authors":"Sandun Jayarathna, Matthew Hoang, Rajeev Badkul, Andrew Hoover","doi":"10.5114/jcb.2023.132697","DOIUrl":"https://doi.org/10.5114/jcb.2023.132697","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the dosimetric impact of brachytherapy applicator displacement during intracavitary (IC) and combined intracavitary/interstitial (IC/IS) high-dose-rate brachytherapy in the treatment of cervical cancer.</p><p><strong>Material and methods: </strong>Data from 27 consecutively treated patients undergoing IC or IC/IS high-dose-rate brachytherapy with tandem and ovoid-based applicators at a single academic medical center were analyzed. Virtual applicator displacements (a single shift of whole applicator with tandem/ovoid/associated needles) of 0 (clinical position), 2, 5, 7, and 10 mm in the inferior direction were modeled on treatment planning CT or MRI scans, with maintaining the same dwell times. Radiation dose to target volumes (D₉₀ of high-risk clinical target volume) and organs at risk (OARs) (D_0.1cc, D_1cc, and D_2cc of bladder, rectum, and sigmoid) were calculated for each virtual applicator shift, and significance of displacements was assessed using general linear model and Kruskal-Wallis test.</p><p><strong>Results: </strong>Mean dose to high-risk clinical target volume (HR-CTV) D₉₀ was 95.7%, 88.9%, 84.6%, and 77.1% of the prescribed dose in clinical position with displacements of 2, 5, 7, and 10 mm, respectively. Rectal D_2cc significantly increased by 28% and 44% at displacement of 7 mm and 10 mm, respectively. IC/IS cases showed relatively greater dosimetric differences than IC cases, with HR-CTV D₉₀ doses of 94.4%, 85.8%, 80.4%, and 72.4% at virtual displacements of 2, 5, 7, and 10 mm, respectively.</p><p><strong>Conclusions: </strong>Applicator displacements of 5 mm or greater result in statistically significant and clinically meaningful decreases in radiation dose to HR-CTV during 3-dimensional high-dose-rate brachytherapy treatment planning, with corresponding increase in radiation dose to the rectum. IC/IS applicator displacements lead to relatively greater differences than those of IC applicators.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"15 5","pages":"334-343"},"PeriodicalIF":1.4,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10669918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138464270","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 rectal dose-reductive techniques in intra-cavitary brachytherapy for cervical cancer: A retrospective analysis.","authors":"Masafumi Sawada,&nbsp;Yutaka Shiraishi,&nbsp;Hirofumi Toyama,&nbsp;Tomoki Tanaka,&nbsp;Ryuichi Kota,&nbsp;Naoyuki Shigematsu","doi":"10.5114/jcb.2023.130842","DOIUrl":"10.5114/jcb.2023.130842","url":null,"abstract":"<p><strong>Purpose: </strong>Rectal complications in radiotherapy for cervical cancer can highly affect quality of life and correlate with rectal dose. Vaginal gauze packing (VP) and rectal retraction (RR) are widely used for rectal dose reduction in high-dose-rate brachytherapy. We aimed to perform a dosimetric comparison of these two methods for three-dimensional image-guided adaptive brachytherapy.</p><p><strong>Material and methods: </strong>We retrospectively examined 50 patients with cervical cancer treated with definitive radiotherapy, including intra-cavitary brachytherapy, performed with VP and RR. We extracted two fractions for each patient: one fraction with VP and the next fraction with RR, and then compared dose-volume parameters. In total, 50 fractions each were analyzed in VP and RR groups. Dose to 90% (D₉₀) of high-risk clinical target volume (HR-CTV), and minimum dose to most exposed 2.0 cm³ of other organs at risk (D_2cm³) for the rectum and bladder were determined from planning computed tomography.</p><p><strong>Results: </strong>There were no significant differences between VP and RR in D₉₀ of HR-CTV (mean: 7.479 Gy and 7.652 Gy, respectively, <i>p</i> = 0.172). The D_2cm³ values for the rectum (mean: 4.234 Gy vs. 4.627 Gy, <i>p</i> = 0.008) and bladder (mean: 5.959 Gy vs. 6.690 Gy, <i>p</i> < 0.001) were significantly lower with VP compared with RR.</p><p><strong>Conclusions: </strong>VP reduced the dose to the rectum and bladder when compared with RR without impairing the dose to CTV.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"15 4","pages":"269-274"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a7/cf/JCB-15-51322.PMC10548429.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156817","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 role of training simulators in interventional radiation therapy (brachytherapy) training: A narrative review.","authors":"Martina Ferioli,&nbsp;Federica Medici,&nbsp;Erika Galietta,&nbsp;Ludovica Forlani,&nbsp;Luca Tagliaferri,&nbsp;Savino Cilla,&nbsp;Silvia Cammelli,&nbsp;Alessio G Morganti,&nbsp;Milly Buwenge","doi":"10.5114/jcb.2023.131240","DOIUrl":"10.5114/jcb.2023.131240","url":null,"abstract":"<p><p>Simulators have revolutionized medical education and training across various disciplines, offering unique advantages in skill acquisition and performance improvement. In the context of interventional radiation therapy (IRT), simulators have emerged as valuable tools for training healthcare professionals in these complex procedures. This narrative review summarized the available evidence on the use of simulators in IRT training, highlighting their impact on proficiency, engagement, and self-confidence as well as their benefits for medical physicists and radiation therapists. A systematic search was conducted in PubMed, resulting in inclusion of 10 papers published since 2009, with 5 of them published since 2020. Publications originated from centers in USA, Ireland, Switzerland, Canada, and Japan, covering a range of IRT settings, including general, prostate, and cervical IRT. The review demonstrated that simulators provide a controlled and realistic environment for skill acquisition, allowing healthcare professionals to practice procedures, optimize image quality, and enhance technical proficiency. The use of simulators addressed the barriers associated with limited caseload and procedural complexity, ultimately contributing to improved education and IRT training. While cost considerations may exist, simulators offer long-term cost-effective solutions, balancing the potential benefits in improving educational outcomes and patient care. Overall, simulators play a crucial role in IRT training, enhancing the skills and competence of healthcare providers and improving access to quality IRT care worldwide. Future research should focus on evaluating the long-term impact of simulation-based training on clinical outcomes and patient satisfaction, exploring different simulation models and training approaches, and addressing region-specific barriers to optimize the utilization of IRT.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"15 4","pages":"290-295"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/96/a7/JCB-15-51392.PMC10548427.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147136","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":"Inter-observer variation of target volume delineation for CT-guided cervical cancer brachytherapy.","authors":"Aysenur Elmali,&nbsp;Fatih Biltekin,&nbsp;Sezin Yuce Sari,&nbsp;Melis Gultekin,&nbsp;Deniz Yuce,&nbsp;Ferah Yildiz","doi":"10.5114/jcb.2023.131242","DOIUrl":"10.5114/jcb.2023.131242","url":null,"abstract":"<p><strong>Purpose: </strong>Delineation is a critical and challenging step in radiotherapy planning. Differences in delineation among observers are common, despite the presence of contouring guidelines. This study aimed to identify the inter-observer variability in the target volume delineation of computed tomography (CT)-guided brachytherapy for cervical cancer.</p><p><strong>Material and methods: </strong>Four radiation oncologists (ROs) with different expertise levels delineated high-risk (HR) and intermediate-risk (IR) clinical target volume (CTV) according to GYN GEC-ESTRO recommendations, in a blinded manner on every CT set of ten locally advanced cervical cancer cases. The most experienced RO's contours were determined as the index and used for comparison. Dice similarity coefficient (DSC) and pairwise Hausdorff distance (HD) metrics were applied to compare the overlap and gross deviations of all contours.</p><p><strong>Results: </strong>Median DSC for HR-CTV and IR-CTV were 0.73 and 0.76, respectively, and a good concordance was achieved for both in majority of contours. While there was no difference in DSC measurements for HR-CTV among the three ROs, RO-3 provided improved DSC values for IR-CTV (<i>p</i> = 0.01). Median HD95 was 5.02 mm and 6.83 mm, and median HDave was 1.69 mm and 2.21 mm for HR-CTV and IR-CTV, respectively. There was no significant difference among ROs in HR-CTV for HD95 or HDave; however, IR-CTV value was significantly improved according to RO-3 (<i>p</i> = 0.01). Case-by-case HD analysis showed no significant inter-observer variations, except for two cases.</p><p><strong>Conclusions: </strong>The inter-observer agreement is generally high for target volumes in CT-guided brachytherapy for cervical cancer. The agreement is lower for IR-CTV than HR-CTV. The individual characteristics of each case and different expertise levels of the ROs may have caused the differences. Despite the good concordance for delineation, dosimetric consequences can still be clinically significant.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"15 4","pages":"253-260"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/5d/JCB-15-51393.PMC10548424.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172507","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":"Evaluation of doses to pelvic lymph node regions from image-guided high-dose-rate interstitial brachytherapy for carcinoma of the uterine cervix.","authors":"Ajeet Kumar Gandhi,&nbsp;Madhup Rastogi,&nbsp;Vachaspati Kumar Mishra,&nbsp;Anoop Kumar Srivastava,&nbsp;Farhana Khatoon,&nbsp;Daya Nand Sharma","doi":"10.5114/jcb.2023.130992","DOIUrl":"10.5114/jcb.2023.130992","url":null,"abstract":"<p><strong>Purpose: </strong>Interstitial brachytherapy (ISBT) is indicated for intact cervical carcinoma (IN-CC) if intracavitary brachytherapy (ICRT) is not feasible and also in vault carcinoma (VA-C). We aimed to evaluate the doses to pelvic lymph node regions in IN-CC and VA-C treated with ISBT.</p><p><strong>Material and methods: </strong>Ten patients (6 IN-CC, 4 VA-C) were chosen for this dosimetric study. IN-CC had a central tandem in addition to the needles. External iliac (EI-N), internal iliac (II-N), obturator (OB-N) and sacral (SA-N) groups of lymph nodes were delineated. A dose of 10 grays (Gy) and 8 Gy each × 2 fractions was prescribed to the target in IN-CC and VA-C respectively. Doses received by 100%, 90% and 50% volume (D₁₀₀, D₉₀, D₅₀) and D_2cc, D_1cc, D_0.1cc were evaluated. Doses to lymph nodal groups in IN-CC vs. VA-C were compared using Student's <i>t</i>-test.</p><p><strong>Results: </strong>For 20 implants, the median number of needles was 18 (range, 16-20). Mean D₉₀ and D_2cc of the combined bilateral OB-N, II-N, EI-N and SA-N groups were 33.62 ±3.46% and 102.94 ±10.71%, 6.98 ±0.65% and 39.69 ±3.64%, 5.1 ±0.51% and 15.4 ±0.8%, 7.76 ±0.95% and 15.36 ±1.09% of the prescribed doses respectively. Patients with a central tandem (IN-CC) received significantly higher doses to external, internal iliac and sacral group of lymph nodes (<i>p</i> < 0.001) as compared to VA-C.</p><p><strong>Conclusions: </strong>In patients with cervical carcinoma treated with ISBT, pelvic lymph node groups received significant doses. The dose contribution to pelvic lymph nodes is higher in patients with intact cervical cancer where a central tandem is used as compared to post-operative patients.</p>","PeriodicalId":51305,"journal":{"name":"Journal of Contemporary Brachytherapy","volume":"15 4","pages":"261-268"},"PeriodicalIF":1.4,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/fe/JCB-15-51350.PMC10548423.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41169112","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}