Conventional High-Dose-Rate Brachytherapy With Concomitant Complementary IMRT Boost: A Novel Approach for Improving Cervical Tumor Dose Coverage
Abstract
Purpose: To investigate the feasibility of combining conventional high-dose-rate (HDR) brachytherapy with a concomitant complementary intensity-modulated radiotherapy (IMRT) boost for improved target coverage in cervical cancers. Methods and Materials: Six patients with cervical cancer underwent conventional HDR (C-HDR) treatment. Computed tomography (CT) and magnetic resonance imaging (MRI) scans were acquired with a CT/MRI-compatible applicator in place. The clinical target volumes (CTVs), defined as the gross target volume with a 3-mm margin and the uterus, were delineated on the CT scans, along with the organs at risk (OARs). The IMRT plans were optimized to generate dose distributions complementing those of C-HDR to cover the CTV while maintaining low doses to the OARs (IMRT-HDR). For comparison, dwell-weight optimized HDR (O-HDR) plans were also generated to cover the CTV and spare the OARs. The three treatment techniques (C-HDR, O-HDR, and IMRT-HDR) were compared. The percentage of volume receiving 95% of the prescription dose (V{sub 95}) was used to evaluate dose coverage to the CTV, and the minimal doses in the 2.0-cm{sup 3} volume receiving the greatest dose were calculated to compare the doses to the OARs. Results: The C-HDR technique provided very poor CTV coverage in 5 cases (V{sub 95} <62%). Although O-HDRmore »
- Authors:
-
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL (United States)
- Medical Statistics Section of the Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL (United States)
- Publication Date:
- OSTI Identifier:
- 21124315
- Resource Type:
- Journal Article
- Journal Name:
- International Journal of Radiation Oncology, Biology and Physics
- Additional Journal Information:
- Journal Volume: 71; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2007.10.064; PII: S0360-3016(07)04474-4; Copyright (c) 2008 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
- Subject:
- 62 RADIOLOGY AND NUCLEAR MEDICINE; BLADDER; BRACHYTHERAPY; CARCINOMAS; COMPUTERIZED TOMOGRAPHY; DOSE RATES; IMAGE PROCESSING; NMR IMAGING; RADIATION DOSE DISTRIBUTIONS; RECTUM; UTERUS
Citation Formats
Duan, Jun, Kim, Robert Y., Elassal, Shaaban, Huiyi, Lin, and Sui, Shen. Conventional High-Dose-Rate Brachytherapy With Concomitant Complementary IMRT Boost: A Novel Approach for Improving Cervical Tumor Dose Coverage. United States: N. p., 2008.
Web. doi:10.1016/j.ijrobp.2007.10.064.
Duan, Jun, Kim, Robert Y., Elassal, Shaaban, Huiyi, Lin, & Sui, Shen. Conventional High-Dose-Rate Brachytherapy With Concomitant Complementary IMRT Boost: A Novel Approach for Improving Cervical Tumor Dose Coverage. United States. https://doi.org/10.1016/j.ijrobp.2007.10.064
Duan, Jun, Kim, Robert Y., Elassal, Shaaban, Huiyi, Lin, and Sui, Shen. 2008.
"Conventional High-Dose-Rate Brachytherapy With Concomitant Complementary IMRT Boost: A Novel Approach for Improving Cervical Tumor Dose Coverage". United States. https://doi.org/10.1016/j.ijrobp.2007.10.064.
@article{osti_21124315,
title = {Conventional High-Dose-Rate Brachytherapy With Concomitant Complementary IMRT Boost: A Novel Approach for Improving Cervical Tumor Dose Coverage},
author = {Duan, Jun and Kim, Robert Y. and Elassal, Shaaban and Huiyi, Lin and Sui, Shen},
abstractNote = {Purpose: To investigate the feasibility of combining conventional high-dose-rate (HDR) brachytherapy with a concomitant complementary intensity-modulated radiotherapy (IMRT) boost for improved target coverage in cervical cancers. Methods and Materials: Six patients with cervical cancer underwent conventional HDR (C-HDR) treatment. Computed tomography (CT) and magnetic resonance imaging (MRI) scans were acquired with a CT/MRI-compatible applicator in place. The clinical target volumes (CTVs), defined as the gross target volume with a 3-mm margin and the uterus, were delineated on the CT scans, along with the organs at risk (OARs). The IMRT plans were optimized to generate dose distributions complementing those of C-HDR to cover the CTV while maintaining low doses to the OARs (IMRT-HDR). For comparison, dwell-weight optimized HDR (O-HDR) plans were also generated to cover the CTV and spare the OARs. The three treatment techniques (C-HDR, O-HDR, and IMRT-HDR) were compared. The percentage of volume receiving 95% of the prescription dose (V{sub 95}) was used to evaluate dose coverage to the CTV, and the minimal doses in the 2.0-cm{sup 3} volume receiving the greatest dose were calculated to compare the doses to the OARs. Results: The C-HDR technique provided very poor CTV coverage in 5 cases (V{sub 95} <62%). Although O-HDR provided excellent gross tumor volume coverage (V{sub 95} {>=}96.9%), it resulted in unacceptably high doses to the OARs in all 6 cases and unsatisfactory coverage to the whole CTV in 3 cases. IMRT-HDR not only yielded substantially improved CTV coverage (average V{sub 95} = 95.3%), but also kept the doses to the bladder and rectum reasonably low. Conclusion: Compared with C-HDR and O-HDR, concomitant IMRT boost complementary to C-HDR not only provided excellent CTV coverage, but also maintained reasonably low doses to the OARs.},
doi = {10.1016/j.ijrobp.2007.10.064},
url = {https://www.osti.gov/biblio/21124315},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 71,
place = {United States},
year = {Tue Jul 01 00:00:00 EDT 2008},
month = {Tue Jul 01 00:00:00 EDT 2008}
}