Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-26T12:26:01.668Z Has data issue: false hasContentIssue false
  • English
  • Français

Impact of CT-based planning and bladder volume changes on the dosimetry of vaginal vault brachytherapy

Published online by Cambridge University Press:  09 February 2021

Jeyaanth Venkatasai Open the ORCID record for Jeyaanth Venkatasai [Opens in a new window] ,
Jebakarunya Ramireddy Open the ORCID record for Jebakarunya Ramireddy [Opens in a new window] ,
Arvind Sathyamurthy Open the ORCID record for Arvind Sathyamurthy [Opens in a new window] ,
Henry Finlay Godson ,
Reka Karuppusami Open the ORCID record for Reka Karuppusami [Opens in a new window] ,
Saikat Das  and
Thomas Samuel Ram Open the ORCID record for Thomas Samuel Ram [Opens in a new window]
Jeyaanth Venkatasai*
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Jebakarunya Ramireddy
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Arvind Sathyamurthy
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Henry Finlay Godson
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Reka Karuppusami
Affiliation:
Department of Biostatistics, Christian Medical College, Vellore, India
Saikat Das
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India Department of Radiation Oncology, AIIMS, Bhopal, India
Thomas Samuel Ram
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
*
Author for correspondence: Dr Jeyaanth Venkatasai, Department of Radiation Oncology, Dr Ida B Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India. Tel: +91-9444275245/0416-228-3145. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

To compare dose to target and organs at risk (OARs) in conventional plan (2D) versus computed tomography (CT)-based three-dimensional (3D) plan in vaginal cuff brachytherapy (VBT) and to compare the effect of bladder distension on target and OARs dosimetry.

Materials and methods:

Post-hysterectomy patients with an indication for VBT were included in the study. All patients underwent planning CT scans with a full bladder and an empty bladder protocol. For each CT, two plans were generated—one library-based 2D plan and another CT-based 3D plan. Dosimetric parameters were recorded for clinical target volume (CTV) and OARs.

Results:

A total of 92 observations were made from data collected from 46 patients. Difference between CTV dose in terms of 2D and 3D plans were not statistically significant for CTV (p = 0·11). Significant reduction in D0·1cc, D1cc and D2cc dose parameters were observed in bladder, rectum, sigmoid and bowel doses with the 3D plan (p < 0·001). Bladder distension showed a 20% reduction in dose for bowel (p < 0·001). Bladder distension also showed a 6·12% (p = 0·047) increase in D2cc, but there was a significant reduction in the mean dose to the bladder.

Conclusion:

Our study demonstrates the dosimetric benefits with 3D CT-based planning for VBT over 2D-based conventional planning and benefit of bladder distension in the reduction of bowel dose without compromising dose to the target volume.

Keywords

bladderCT-based planninggynaecological cancerVaginal brachytherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 321 - 327
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This article was originally published without naming one of the authors, Saikat Das. This error has now been corrected and a corrigendum can be found at https://doi.org/10.1017/S1460396921000534.

References

Bray, F, Ferlay, J, Soerjomataram, I et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394–424.CrossRefGoogle ScholarPubMed
India Human Papillomavirus and Related Diseases Report, 2019. https://www.hpvcentre.net/statistics/reports/XWX.pdf. Accessed on 20th October 2020.Google Scholar
Balasubramaniam, G, Sushama, S, Rasika, B et al. Hospital-based study of endometrial cancer survival in Mumbai, India. Asian Pac J Cancer Prev 2013; 14: 977–980.CrossRefGoogle ScholarPubMed
Small, W, Beriwal, S, Demanes, D J et al. American Brachytherapy Society consensus guidelines for adjuvant vaginal cuff brachytherapy after hysterectomy. Brachytherapy 2012; 11: 58–67.CrossRefGoogle ScholarPubMed
Nout, R A, Smit, V T H B M, Putter, H et al. Vaginal brachytherapy versus pelvic external beam radiotherapy for patients with endometrial cancer of high-intermediate risk (PORTEC-2): an open-label, non-inferiority, randomised trial. Lancet 2010; 375: 816–823.CrossRefGoogle ScholarPubMed
International Commission on Radiation Units and Measurements (ICRU) Report 38. Available from: https://icru.org/home/reports/dose-and-volume-specification-for-reporting-intracavitary-therapy-in-gynecology-report-38. Accessed on 20th October 2020.Google Scholar
Dimopoulos, J C A, Petrow, P, Tanderup, K et al. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiother Oncol 2012; 103: 113–122.CrossRefGoogle Scholar
Pathy, S, Kumar, R, Sharma, D N, Biswas, R, Sharma, S, Binjola, A. Small Bowel Doses in Vaginal Cuff Brachytherapy in Post-Hysterectomy Cervical Cancer Patients: A Volumetric Dosimetric Study in Patients Treated with Point Based Technique. Brachytherapy 2018; 17: S120–S121.CrossRefGoogle Scholar
Gay, H A, Barthold, H J, O’Meara, E et al. Pelvic Normal Tissue Contouring Guidelines for Radiation Therapy: A Radiation Therapy Oncology Group Consensus Panel Atlas. Int J Radiat Oncol Biol Phys 2012; 83: e353–e362.CrossRefGoogle ScholarPubMed
Viswanathan, A N, Moughan, J, Miller, B E et al. NRG Oncology/RTOG 0921: a phase 2 study of postoperative intensity-modulated radiotherapy with concurrent cisplatin and bevacizumab followed by carboplatin and paclitaxel for patients with endometrial cancer. Cancer 2015; 121: 2156–2163.CrossRefGoogle ScholarPubMed
Harkenrider, M M, Grover, S, Erickson, B A et al. Vaginal brachytherapy for postoperative endometrial cancer: 2014 Survey of the American Brachytherapy Society. Brachytherapy 2016; 15: 23–29.CrossRefGoogle ScholarPubMed
Kim, H, Kim, H, Beriwal, S. Is There Any Advantage to 3D Planning for Vaginal Cuff Brachytherapy? Int J Radiat Oncol Biol Phys 2011; 81: S474.CrossRefGoogle Scholar
Holloway, C L, Macklin, E A, Cormack, R A, Viswanathan, A N. Should the organs at risk be contoured in vaginal cuff brachytherapy? Brachytherapy 2011; 10: 313–317.CrossRefGoogle ScholarPubMed
Kim, R Y, Shen, S, Lin, H Y, Spencer, S A, De Los Santos, J. Effects of bladder distension on organs at risk in 3D image-based planning of intracavitary brachytherapy for cervical cancer. Int J Radiat Oncol Biol Phys 2010; 76 (2): 485–489.CrossRefGoogle ScholarPubMed
Mahantshetty, U, Shetty, S, Majumder, D et al. Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study. J Contemp Brachytherapy 2017; 9 (2): 112.CrossRefGoogle ScholarPubMed
Hoskin, P J, Vidler, K. Vaginal vault brachytherapy: the effect of varying bladder volumes on normal tissue dosimetry. Br J Radiol 2000; 73: 864–866.CrossRefGoogle ScholarPubMed
Hung, J, Shen, S, De Los Santos, J F. Image-Based 3D treatment planning for vaginal cylinder brachytherapy: dosimetric effects of bladder filling on organs at risk. Int J Radiat Oncol Biol Phys 2012; 83: 980–985.CrossRefGoogle ScholarPubMed
Guler, O C, Onal, C, Acibuci, I. Effects of bladder distension on dose distribution of vaginal vault brachytherapy in patients with endometrial cancer. J Contemp Brachytherapy 2015; 6: 371–376.Google ScholarPubMed
Stewart, A J, Cormack, R A, Lee, H et al. Prospective clinical trial of bladder filling and three-dimensional dosimetry in high-dose-rate vaginal cuff brachytherapy. Int J Radiat Oncol Biol Phys 2008; 72: 843–848.CrossRefGoogle ScholarPubMed
Kobzda, J D, Cikowska-Wozniak, E, Michalska, M et al. Three-Dimensional dosimetry of the full and empty bladder in high dose rate vaginal cuff brachytherapy. Int J Gynecol Cancer 2014; 24: 923–927.CrossRefGoogle ScholarPubMed
Martell, K, Doll, C, Barnes, E et al. Radiotherapy Practices in Post-Operative Endometrial Cancer: A Survey of the ABS Membership. Brachytherapy 2019; 18: S32–S33.CrossRefGoogle ScholarPubMed