Comparison of CT-based volumetric dosimetry with traditional prescription points in the treatment of cervical cancer with PDR brachytherapy

Lowrey, Nicola, Nilsson, Sanna, Moutrie, Zoe, Chan, Philip and Cheuk, Robyn (2015) Comparison of CT-based volumetric dosimetry with traditional prescription points in the treatment of cervical cancer with PDR brachytherapy. Journal of Medical Imaging and Radiation Oncology, 59 5: 640-645. doi:10.1111/1754-9485.12341


Author Lowrey, Nicola
Nilsson, Sanna
Moutrie, Zoe
Chan, Philip
Cheuk, Robyn
Title Comparison of CT-based volumetric dosimetry with traditional prescription points in the treatment of cervical cancer with PDR brachytherapy
Journal name Journal of Medical Imaging and Radiation Oncology   Check publisher's open access policy
ISSN 1754-9485
1754-9477
Publication date 2015-10-01
Year available 2015
Sub-type Article (original research)
DOI 10.1111/1754-9485.12341
Open Access Status Not yet assessed
Volume 59
Issue 5
Start page 640
End page 645
Total pages 6
Place of publication Richmond, Victoria, Australia
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
Introduction: The traditional use of two-dimensional geometric prescription points in intracavitary brachytherapy planning for locally advanced cervical cancer is increasingly being replaced by three-dimensional (3D) planning. This study aimed to directly compare the two planning methods to validate that CT planning provides superior dosimetry for both tumour and organs at risk (OARs) in our department.

Methods: The CT planning data of 10 patients with locally advanced cervical cancer was audited. For each CT dataset, two new brachytherapy plans were created, comparing the dosimetry of conventional American Brachytherapy Society points and 3D-optimised volumes created for the high-risk clinical target volume (HR CTV) and OARs. Total biologically equivalent doses for these structures were calculated using the modified EQD2 formula and comparative dose-volume histogram (DVH) analysis performed.

Results: DVH analysis revealed that for the 3D-optimised plans, the prescription aim of D90 ≥ 100% was achieved for the HR CTV in all 10 patients. However, when prescribing to point A, only 50% of the plans achieved the minimum required dose to the HR CTV. Rectal and bladder dose constraints were met for all 3D-optimised plans but exceeded in two and one of the conventional plans, respectively.

Conclusions: This study confirms that the regionally relevant practice of CT-based 3D-optimised planning results in improved tumour dose coverage compared with traditional points-based planning methods and also improves dose to the rectum and bladder.
Keyword Brachytherapy
Cervix cancer
Computed tomography
Dosimetry
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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