The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results

Journal Article · Thu Jun 01 00:00:00 EDT 2006 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2006.0· OSTI ID:20793524

Kirisits, Christian ^[1]; Lang, Stefan ^[1]; Dimopoulos, Johannes ^[1]; Berger, Daniel ^[1]; Georg, Dietmar ^[1]; Poetter, Richard ^[1]

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1. Department of Radiotherapy and Radiobiology, Medical University of Vienna, Vienna (Austria)

Purpose: To present a combined intracavitary and interstitial dedicated applicator and magnetic resonance imaging (MRI) treatment planning for cervical cancer brachytherapy. Methods and Materials: A modified ring applicator allows interstitial needles to be implanted in parallel to the intrauterine tandem. MRI treatment planning based on a standard loading pattern with stepwise dwell weight adaptation and needle loading is performed to achieve optimal dose coverage and sparing of organs at risk. Dose constraints are applied for dose-volume histogram parameters. Results: The use of additional interstitial needles provides prescription dose up to 15 mm lateral to point A. Twenty-two patients with high-risk clinical target volumes of mean 44 cm{sup 3} were treated with a mean prescribed total dose of 85 Gy (biologically equivalent to 2 Gy fractionation, {alpha}/{beta} = 10 Gy) and 93% coverage (V100). The dose to organs at risk was within standard limits for intracavitary brachytherapy alone. Conclusions: A combined interstitial-intracavitary applicator results in reproducible implants for cervical cancer brachytherapy. MRI-based treatment planning based on a target concept, dose-volume constraints, and limitations for the relative dwell weight allows for an increase in target coverage, treated volume, and total dose without increasing the dose to critical structures.

• OSTI ID: 20793524
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 65, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2006.01.036; PII: S0360-3016(06)00161-1; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
FRACTIONATED IRRADIATION
HEALTH HAZARDS
NEOPLASMS
NMR IMAGING
ORGANS
PLANNING
RADIATION DOSES
RADIATION SOURCE IMPLANTS