Simulation analysis of optimized brachytherapy for uterine cervical cancer: Can we select the best brachytherapy modality depending on tumor size?

Abstract:

PURPOSE:To choose the optimal brachytherapeutic modality for uterine cervical cancer, we performed simulation analysis. METHODS AND MATERIALS:For each high-risk clinical target volume (HR CTV), we compared four modalities [classical conventional intracavitary brachytherapy (ConvICBT), Image-guided ICBT (IGICBT), intracavitary/interstitial brachytherapy (ICISBT), and interstitial brachytherapy (ISBT) with perineal approach] using dose-volume histograms using eight sizes of HR CTV (2 × 2 × 2 cm to 7 × 4 × 4 cm) and organs at risk model. RESULTS:In ConvICBT, the doses covered 90% of the HR CTV [D90(HR CTV)] decreased from 197% prescribed dose (PD) for the HR CTV size (2 × 2 × 2 cm) to 73% PD for 5 × 4 × 4 cm, whereas the other three modalities could achieve 100% PD for all HR CTV sizes. The minimum doses received by the maximally irradiated 2-cm(3) volumes for organs at risks of IGICBT demonstrated lower values than those of ConvICBT for the HR CTV size of 4 × 3 × 3 cm or smaller. ICISBT demonstrated lower values than those of IGICBT for 4 × 3 × 3 cm or larger. ISBT demonstrated lowest values for 5 × 4 × 4 cm or larger. CONCLUSIONS:HR CTV size of 4 × 3 × 3 cm seems to be a threshold volume in this simulation analysis, and IGICBT is a better choice for smaller HR CTV than the threshold volume. On larger HR CTV, ICISBT or ISBT is the better choice.

journal_name

Brachytherapy

journal_title

Brachytherapy

authors

Yoshida K,Yamazaki H,Kotsuma T,Takenaka T,Ueda MM,Miyake S,Tsujimoto Y,Masui K,Yoshioka Y,Sumida I,Uesugi Y,Shimbo T,Yoshikawa N,Yoshioka H,Tanaka E,Narumi Y

doi

10.1016/j.brachy.2015.10.002

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

57-64

issue

1

eissn

1538-4721

issn

1873-1449

pii

S1538-4721(15)00566-8

journal_volume

15

pub_type

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