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Dosimetric evaluation of tandem-based cervical high-dose-rate brachytherapy treatment planning using American Brachytherapy Society 2011 recommendations

Published online by Cambridge University Press:  15 April 2016

Manish K. Goyal ,
T. S. Kehwar ,
Jayanand Manjhi ,
Jerry L. Barker ,
Bret H. Heintz ,
Kathleen L. Shide  and
D. V. Rai
Manish K. Goyal
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA Department of Biomedical Engineering, Shobhit University, Meerut, India
T. S. Kehwar*
Affiliation:
Department of Radiation Oncology, Pinnacle Health Cancer Center, Harrisburg, PA, USA
Jayanand Manjhi
Affiliation:
Department of Biomedical Engineering, Shobhit University, Meerut, India
Jerry L. Barker
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
Bret H. Heintz
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
Kathleen L. Shide
Affiliation:
Department of Radiation Oncology, Texas Oncology, Fort Worth, TX, USA
D. V. Rai
Affiliation:
Department of Biomedical Engineering, Shobhit University, Meerut, India
*
Correspondence to: T. S. Kehwar, Department of Radiation Oncology, Pinnacle Health Cancer Center, Harrisburg, PA 17109, USA. Tel: 001 717 724 6734. E-mail: drkehwar@gmail.com
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Abstract

Purpose

This study evaluated dosimetric parameters for cervical high-dose-rate (HDR) brachytherapy treatment using varying dose prescription methods.

Methods

This study includes 125 tandem-based cervical HDR brachytherapy treatment plans of 25 patients who received HDR brachytherapy. Delineation of high-risk clinical target volumes (HR-CTVs) and organ at risk were done on original computed tomographic images. The dose prescription point was defined as per International Commission in Radiation Units and Measurements Report Number 38 (ICRU-38), also redefined using American Brachytherapy Society (ABS) 2011 criteria. The coverage index (V100) for each HR-CTV was calculated using dose volume histogram parameters. A plot between HR-CTV and V100 was plotted using the best-fit linear regression line (least-square fit analysis).

Results

Mean prescribed dose to ICRU-38 Point A was 590·47±28·65 cGy, and to ABS Point A was 593·35±30·42 cGy. There was no statistically significant difference between planned ICRU-38 and calculated ABS Point A doses (p=0·23). The plot between HR-CTV and V100 is well defined by the best-fit linear regression line with a correlation coefficient of 0·9519.

Conclusion

For cervical HDR brachytherapy, dose prescription to an arbitrarily defined point (e.g., Point A) does not provide consistent coverage of HR-CTV. The difference in coverage between two dose prescription approaches increases with increasing CTV. Our ongoing work evaluates the dosimetric consequences of volumetric dose prescription approaches for these patients.

Keywords

American Brachytherapy Societycervical cancerhigh-dose-rate brachytherapyintracavitary brachytherapyPoint A
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 3 , September 2016 , pp. 283 - 289
Copyright
© Cambridge University Press 2016 

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