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

Abstract

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.

Authors:
 [1];  [1];  [1];  [1];  [1];  [1]
  1. Department of Radiotherapy and Radiobiology, Medical University of Vienna, Vienna (Austria)
Publication Date:
OSTI Identifier:
20793524
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 65; Journal 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); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRACHYTHERAPY; FRACTIONATED IRRADIATION; HEALTH HAZARDS; NEOPLASMS; NMR IMAGING; ORGANS; PLANNING; RADIATION DOSES; RADIATION SOURCE IMPLANTS

Citation Formats

Kirisits, Christian, Lang, Stefan, Dimopoulos, Johannes, Berger, Daniel, Georg, Dietmar, and Poetter, Richard. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2006.0.
Kirisits, Christian, Lang, Stefan, Dimopoulos, Johannes, Berger, Daniel, Georg, Dietmar, & Poetter, Richard. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results. United States. https://doi.org/10.1016/J.IJROBP.2006.0
Kirisits, Christian, Lang, Stefan, Dimopoulos, Johannes, Berger, Daniel, Georg, Dietmar, and Poetter, Richard. 2006. "The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results". United States. https://doi.org/10.1016/J.IJROBP.2006.0.
@article{osti_20793524,
title = {The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer: Design, application, treatment planning, and dosimetric results},
author = {Kirisits, Christian and Lang, Stefan and Dimopoulos, Johannes and Berger, Daniel and Georg, Dietmar and Poetter, Richard},
abstractNote = {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.},
doi = {10.1016/J.IJROBP.2006.0},
url = {https://www.osti.gov/biblio/20793524}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 2,
volume = 65,
place = {United States},
year = {Thu Jun 01 00:00:00 EDT 2006},
month = {Thu Jun 01 00:00:00 EDT 2006}
}