Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning
Objective To analyze tumour response and toxicity with respect to cumulative radiotherapy dose to target and organs at risk (OARs) with computed tomography (CT)-based image guided adaptive brachytherapy planning for locally advanced carcinoma cervix. Methods Patients were treated with two-dimensiona...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Obstetrics and Gynecology
2024-01-01
|
| Series: | Obstetrics & Gynecology Science |
| Subjects: | |
| Online Access: | http://ogscience.org/upload/pdf/ogs-23048.pdf |
| _version_ | 1827380371832963072 |
|---|---|
| author | Suman Dhabal Abhishek Basu Saikat Sau Sourav Sau Pradip Kumar Maiti Abhay Chakravarty |
| author_facet | Suman Dhabal Abhishek Basu Saikat Sau Sourav Sau Pradip Kumar Maiti Abhay Chakravarty |
| author_sort | Suman Dhabal |
| collection | DOAJ |
| description | Objective To analyze tumour response and toxicity with respect to cumulative radiotherapy dose to target and organs at risk (OARs) with computed tomography (CT)-based image guided adaptive brachytherapy planning for locally advanced carcinoma cervix. Methods Patients were treated with two-dimensional concurrent chemoradiotherapy to whole pelvis followed by intracavitary brachytherapy (ICBT) with dose prescription to point ‘A’. CT image-based delineation of high-risk clinical target volume (HR-CTV), urinary bladder, rectum and sigmoid colon was done with generation of dose-volume histogram (DVH) data and optimization of doses to target and OARs. Follow up assessments were done for response of disease and toxicity with generation of data for statistical analysis. Results One hundred thirty-six patients were enrolled in the study. Delineated volume of HR-CTV ranged from 20.9 to 37.1 mL, with median value of 30.2 mL. The equivalent dose in 2 Gy per fraction (EQD2) for point ‘A’ ranged from 71.31 to 79.75 Gy with median value of 75.1 Gy and EQD2 HR-CTV D90 ranged from 71.9 to 89.7 Gy with median value of 85.1 Gy. 69.2% of patients showed complete response and after median follow-up of 25 months, 50 patients remained disease free, of whom, 74.0% had received ≥85 Gy to HR-CTV D90 versus 26.0% receiving <85 Gy to HR-CTV D90. Conclusions Amidst the unavailability of magnetic resonance imaging facilities in low middle income countries, incorporation of CT-image based treatment planning into routine practice for ICBT provides the scope to delineate volumes of target and OARs and to generate DVH data, which can prove to be a better surrogate for disease response and toxicity. |
| first_indexed | 2024-03-08T13:32:52Z |
| format | Article |
| id | doaj.art-d8f9043849e745c0bafd83b760ad5617 |
| institution | Directory Open Access Journal |
| issn | 2287-8572 2287-8580 |
| language | English |
| last_indexed | 2024-03-08T13:32:52Z |
| publishDate | 2024-01-01 |
| publisher | Korean Society of Obstetrics and Gynecology |
| record_format | Article |
| series | Obstetrics & Gynecology Science |
| spelling | doaj.art-d8f9043849e745c0bafd83b760ad56172024-01-17T07:57:54ZengKorean Society of Obstetrics and GynecologyObstetrics & Gynecology Science2287-85722287-85802024-01-01671677510.5468/ogs.230488778Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planningSuman Dhabal0Abhishek Basu1Saikat Sau2Sourav Sau3Pradip Kumar Maiti4Abhay Chakravarty5 Department of Radiation Oncology, Burdwan Medical College, Purba Bardhaman, West Bengal, India Department of Radiation Oncology, Burdwan Medical College, Purba Bardhaman, West Bengal, India Department of Cardiology, Burdwan Medical College, Purba Bardhaman, West Bengal, India Department of Radiation Oncology, Burdwan Medical College, Purba Bardhaman, West Bengal, India Department of Radiation Oncology, Agartala Government Medical College, Agartala, India Department of Radiation Oncology, Burdwan Medical College, Purba Bardhaman, West Bengal, IndiaObjective To analyze tumour response and toxicity with respect to cumulative radiotherapy dose to target and organs at risk (OARs) with computed tomography (CT)-based image guided adaptive brachytherapy planning for locally advanced carcinoma cervix. Methods Patients were treated with two-dimensional concurrent chemoradiotherapy to whole pelvis followed by intracavitary brachytherapy (ICBT) with dose prescription to point ‘A’. CT image-based delineation of high-risk clinical target volume (HR-CTV), urinary bladder, rectum and sigmoid colon was done with generation of dose-volume histogram (DVH) data and optimization of doses to target and OARs. Follow up assessments were done for response of disease and toxicity with generation of data for statistical analysis. Results One hundred thirty-six patients were enrolled in the study. Delineated volume of HR-CTV ranged from 20.9 to 37.1 mL, with median value of 30.2 mL. The equivalent dose in 2 Gy per fraction (EQD2) for point ‘A’ ranged from 71.31 to 79.75 Gy with median value of 75.1 Gy and EQD2 HR-CTV D90 ranged from 71.9 to 89.7 Gy with median value of 85.1 Gy. 69.2% of patients showed complete response and after median follow-up of 25 months, 50 patients remained disease free, of whom, 74.0% had received ≥85 Gy to HR-CTV D90 versus 26.0% receiving <85 Gy to HR-CTV D90. Conclusions Amidst the unavailability of magnetic resonance imaging facilities in low middle income countries, incorporation of CT-image based treatment planning into routine practice for ICBT provides the scope to delineate volumes of target and OARs and to generate DVH data, which can prove to be a better surrogate for disease response and toxicity.http://ogscience.org/upload/pdf/ogs-23048.pdfcancer of the uterine cervixhigh dose rate brachytherapyintracavitary radiotherapycomputed tomographydose volume histogram |
| spellingShingle | Suman Dhabal Abhishek Basu Saikat Sau Sourav Sau Pradip Kumar Maiti Abhay Chakravarty Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning Obstetrics & Gynecology Science cancer of the uterine cervix high dose rate brachytherapy intracavitary radiotherapy computed tomography dose volume histogram |
| title | Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning |
| title_full | Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning |
| title_fullStr | Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning |
| title_full_unstemmed | Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning |
| title_short | Clinical outcome after high dose rate intracavitary brachytherapy with traditional point ‘A’ dose prescription in locally advanced carcinoma of uterine cervix: dosimetric analysis from the perspective of computed tomography imaging-based 3-dimensional treatment planning |
| title_sort | clinical outcome after high dose rate intracavitary brachytherapy with traditional point a dose prescription in locally advanced carcinoma of uterine cervix dosimetric analysis from the perspective of computed tomography imaging based 3 dimensional treatment planning |
| topic | cancer of the uterine cervix high dose rate brachytherapy intracavitary radiotherapy computed tomography dose volume histogram |
| url | http://ogscience.org/upload/pdf/ogs-23048.pdf |
| work_keys_str_mv | AT sumandhabal clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning AT abhishekbasu clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning AT saikatsau clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning AT souravsau clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning AT pradipkumarmaiti clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning AT abhaychakravarty clinicaloutcomeafterhighdoserateintracavitarybrachytherapywithtraditionalpointadoseprescriptioninlocallyadvancedcarcinomaofuterinecervixdosimetricanalysisfromtheperspectiveofcomputedtomographyimagingbased3dimensionaltreatmentplanning |