Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers.

IF 1.1 4区 医学 Q4 ONCOLOGY Journal of Contemporary Brachytherapy Pub Date : 2022-10-01 DOI:10.5114/jcb.2022.121175
Michelina Casale, Lorena Draghini, Fabio Trippa, Sara Costantini, Lisa Vicenzi, Letizia Tesei, Alessandro Di Marzo, Fabio Arcidiacono, Marco Italiani, Ernesto Maranzano
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Abstract

Purpose: To evaluate the reliability of algebraic sum with respect to rigid fusion of treatment plans related to adjuvant external beam pelvic radiotherapy (APR) and vaginal cuff high-dose-rate brachytherapy (BT) in uterine cancer patients.

Material and methods: For algebraic sum, APR and BT doses were mathematically added. Rigid fusion was realized overlapping computed tomography (CT) images of APR and BT treatment plans. Rectum and bladder were considered reference organs at risk (OARs). Following dose (D) parameters were examined: Dmax (0.5 cc), D20% and D50% for rectum, Dmax (0.5 cc) and D50% for bladder; for each parameter, differences between the two adopted methods were reported as Δ-values.

Results: Twenty uterine cancer patients submitted to radical surgery followed by APR plus vaginal cuff BT were reviewed. APR was done with a dose of 25 × 2 Gy. All patients also receveid a vaginal cuff boost with BT at the dose of 2 × 5 Gy. Differences between mean cumulative doses calculated with rigid fusion and algebraic sum were evaluated. For the rectum and bladder ΔD50%, there were no significant differences, and BT contribution resulted minimal. An apparent significant difference value was registered in bladder ΔDmax (0.5 cc). No toxicity was observed.

Conclusions: In uterine cancer patients submitted to APR and vaginal cuff BT, algebraic sum and rigid plan fusion of doses allowed to obtain similar results in evaluating cumulative OARs' doses. Further investigations and increased number of patients are recommended to confirm our findings.

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评估子宫癌辅助盆腔放疗和阴道袖带近距离放疗累积剂量的代数和可靠性。
目的:评价子宫癌患者辅助外束盆腔放疗(APR)与阴道袖带高剂量率近距离放疗(BT)治疗方案刚性融合的代数和可靠性。材料与方法:用数学方法将APR和BT剂量相加进行代数求和。将APR和BT治疗方案的CT图像重叠进行刚性融合。直肠和膀胱被认为是危险参考器官(OARs)。检测以下剂量(D)参数:直肠Dmax (0.5 cc)、D20%和D50%,膀胱Dmax (0.5 cc)和D50%;对于每个参数,两种方法之间的差异报告为Δ-values。结果:回顾性分析20例子宫癌根治术后行APR +阴道袖带BT治疗的病例。APR的剂量为25 × 2 Gy。所有患者还接受了2 × 5 Gy剂量的BT阴道袖带增强。用刚性融合和代数和计算的平均累积剂量之间的差异进行了评估。对于直肠和膀胱ΔD50%,没有显著差异,BT的贡献最小。膀胱ΔDmax (0.5 cc)有显著差异。未观察到毒性。结论:子宫癌患者行APR和阴道袖带BT时,剂量的代数和和和刚性计划融合可获得相似的剂量评价结果。建议进一步调查和增加患者数量来证实我们的发现。
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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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