Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)
(1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxici...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-11-01
|
| Series: | Biomedicines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9059/9/11/1629 |
| _version_ | 1797511145469247488 |
|---|---|
| author | Tamer Soror Ramin Chafii Valentina Lancellotta Luca Tagliaferri György Kovács |
| author_facet | Tamer Soror Ramin Chafii Valentina Lancellotta Luca Tagliaferri György Kovács |
| author_sort | Tamer Soror |
| collection | DOAJ |
| description | (1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxicities. (2) Methods: 121 patients were treated. Group A (82) received 21 Gy in three fractions. Group B (39) received 20 Gy in four fractions. The dose was prescribed at a 5 mm depth or to the applicator surface according to the distance between the applicator and the rectum. In vivo dosimetry measured the dose of the rectum and/or urinary bladder. With a high measured dose, the dose prescription was changed from a 5 mm depth to the applicator surface. (3) Results: The median age was 66 years with 58.8 months mean follow-up. The dose prescription was changed in 20.7% of group A and in 41% of group B. Most toxicities were grade 1–2. Acute urinary toxicities were significantly higher in group A. The rates of acute and late urinary toxicities were significantly higher with a mean bladder dose/fraction of >2.5 Gy and a total bladder dose of >7.5 Gy. One patient had a vaginal recurrence. (4) Conclusions: Both schedules have excellent local control and acceptable rates of toxicities. Using in vivo dosimetry-based biological planning yielded an acceptable dose to the bladder and rectum. |
| first_indexed | 2024-03-10T05:41:19Z |
| format | Article |
| id | doaj.art-72b51afaad9743568ded63bddfb66880 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-10T05:41:19Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-72b51afaad9743568ded63bddfb668802023-11-22T22:31:04ZengMDPI AGBiomedicines2227-90592021-11-01911162910.3390/biomedicines9111629Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)Tamer Soror0Ramin Chafii1Valentina Lancellotta2Luca Tagliaferri3György Kovács4Radiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, GermanyRadiation Oncology Department, University of Lübeck/UKSH-CL, 23562 Lübeck, GermanyUOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, ItalyUOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, ItalyGemelli-INTERACTS, Università Cattolica del Sacro Cuore, 00168 Roma, Italy(1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxicities. (2) Methods: 121 patients were treated. Group A (82) received 21 Gy in three fractions. Group B (39) received 20 Gy in four fractions. The dose was prescribed at a 5 mm depth or to the applicator surface according to the distance between the applicator and the rectum. In vivo dosimetry measured the dose of the rectum and/or urinary bladder. With a high measured dose, the dose prescription was changed from a 5 mm depth to the applicator surface. (3) Results: The median age was 66 years with 58.8 months mean follow-up. The dose prescription was changed in 20.7% of group A and in 41% of group B. Most toxicities were grade 1–2. Acute urinary toxicities were significantly higher in group A. The rates of acute and late urinary toxicities were significantly higher with a mean bladder dose/fraction of >2.5 Gy and a total bladder dose of >7.5 Gy. One patient had a vaginal recurrence. (4) Conclusions: Both schedules have excellent local control and acceptable rates of toxicities. Using in vivo dosimetry-based biological planning yielded an acceptable dose to the bladder and rectum.https://www.mdpi.com/2227-9059/9/11/1629interventional radiotherapyvaginal-cuff brachytherapyHDR brachytherapyin vivo dosimetryendometrial cancerbiological planning |
| spellingShingle | Tamer Soror Ramin Chafii Valentina Lancellotta Luca Tagliaferri György Kovács Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) Biomedicines interventional radiotherapy vaginal-cuff brachytherapy HDR brachytherapy in vivo dosimetry endometrial cancer biological planning |
| title | Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) |
| title_full | Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) |
| title_fullStr | Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) |
| title_full_unstemmed | Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) |
| title_short | Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy) |
| title_sort | biological planning of radiation dose based on in vivo dosimetry for postoperative vaginal cuff hdr interventional radiotherapy brachytherapy |
| topic | interventional radiotherapy vaginal-cuff brachytherapy HDR brachytherapy in vivo dosimetry endometrial cancer biological planning |
| url | https://www.mdpi.com/2227-9059/9/11/1629 |
| work_keys_str_mv | AT tamersoror biologicalplanningofradiationdosebasedoninvivodosimetryforpostoperativevaginalcuffhdrinterventionalradiotherapybrachytherapy AT raminchafii biologicalplanningofradiationdosebasedoninvivodosimetryforpostoperativevaginalcuffhdrinterventionalradiotherapybrachytherapy AT valentinalancellotta biologicalplanningofradiationdosebasedoninvivodosimetryforpostoperativevaginalcuffhdrinterventionalradiotherapybrachytherapy AT lucatagliaferri biologicalplanningofradiationdosebasedoninvivodosimetryforpostoperativevaginalcuffhdrinterventionalradiotherapybrachytherapy AT gyorgykovacs biologicalplanningofradiationdosebasedoninvivodosimetryforpostoperativevaginalcuffhdrinterventionalradiotherapybrachytherapy |