Point A vs. HR-CTV D90 in MRI-based cervical brachytherapy of small and large lesions Journal Article


Authors: Harmon, G; Diak, A.; Shea, S. M.; Yacoub, J. H.; Small, W., Jr; Harkenrider, M. M.
Article Title: Point A vs. HR-CTV D90 in MRI-based cervical brachytherapy of small and large lesions
Abstract: PURPOSE: To evaluate the dosimetric benefits of MRI-based brachytherapy in small and large high-risk clinical target volume (HR-CTV) in cervical cancer. METHODS AND MATERIALS: Twenty-eight fractions obtained from sixteen cervical cancer patients treated with MRI-based high-dose-rate brachytherapy with standard tandem and ovoid applicators were used; original fractions were optimized to HR-CTV D90. Fractions were separated based on the median volume into small and large (HR-CTV 25 cm3) lesion groups. Retrospective plans prescribed to Point A were created for each fraction. D0.1 cc, D2 cc, and International Commission of Radiation Unit and Measurements (ICRU) points were used to compare Point A vs. HR-CTV D90 plans for bladder, rectum, and sigmoid. RESULTS: In the small lesion group, Point A plans vs. HR-CTV D90 plans had significantly higher D0.1 cc, D2 cc, and ICRU points for bladder, rectum, and sigmoid (p 25 cm3) lesion groups. Retrospective plans prescribed to Point A were created for each fraction. D0.1 cc, D2 cc, and International Commission of Radiation Unit and Measurements (ICRU) points were used to compare Point A vs. HR-CTV D90 plans for bladder, rectum, and sigmoid. RESULTS: In the small lesion group, Point A plans vs. HR-CTV D90 plans had significantly higher D0.1 cc, D2 cc, and ICRU points for bladder, rectum, and sigmoid (p 25 cm3. Incorporation of interstitial needles for patients with larger HR-CTV is likely the best method to decrease dose to OARs and improve tumor coverage.
Journal Title: Brachytherapy
ISSN: 1873-1449; 1538-4721
Publisher: Unknown  
Journal Place: United States
Date Published: 2016
Language: ENG
DOI/URL:
Notes: LR: 20161004; CI: Copyright (c) 2016; JID: 101137600; OTO: NOTNLM; 2016/06/22 [received]; 2016/08/13 [revised]; 2016/08/25 [accepted]; aheadofprint