Abstract
Purpose Brachytherapy (BT) techniques have historically used a two-dimensional nonvolumetric (NV) system involving dose prescribed to a point fixed in space. We compared dosimetric, toxicity, and oncologic outcomes for volumetric planning (3DV) versus CT point-based planning. Methods and Materials Patients treated with external beam radiation therapy and high dose rate (HDR) intracavitary BT were included (n = 71). Patients planned with NV BT treated from 2009 to 2011 (n = 37) were compared to patients planned with 3DV BT treated from 2012 to 2014 (n = 34). Investigators delineated volumes for organs at risk clinical target volumes for the 2009–2011 NV cohort. Acute and chronic toxicity data were graded. Results The mean HDR clinical target volume D90 received in the NV and 3DV cohorts were significantly different (p < 0.001). The mean dose to point A was significantly higher in the NV cohort than in the 3DV cohort (p < 0.001). There were significantly more Grade 3 or higher gastrointestinal toxicities in the NV cohort (p = 0.048). There was a nonsignificant trend toward improved oncologic outcomes for patients undergoing CT-based planning. Conclusions 3DV BT allows for a significant reduction of dose to critical structures, resulting in decreased gastrointestinal toxicity, while delivering noninferior doses to the high-risk clinical target volume. Outcomes were improved in the 3D cohort trending toward statistical significance.
Original language | English (US) |
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Pages (from-to) | 943-948 |
Number of pages | 6 |
Journal | Brachytherapy |
Volume | 16 |
Issue number | 5 |
DOIs | |
State | Published - Sep 2017 |
Keywords
- Brachytherapy
- Cervical cancer
- Image-guided
- Nonvolumetric
- Point-based
- STIC
- Volumetric
ASJC Scopus subject areas
- Oncology
- Radiology Nuclear Medicine and imaging