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Adaptive brachytherapy for cervical cancer in combined 1.5 T MR/HDR suite: Impact of repeated imaging.
Van Vliet-van den Ende, Katelijne M; Hoogendoorn-Mulder, Paulien G; Schokker, Rogier I; Moerland, Marinus A; Kroon, Petra S; Roesink, Judith M; Fajardo, Raquel Dávila; Van der Leij, Femke; Jürgenliemk-Schulz, Ina M.
Afiliación
  • Van Vliet-van den Ende KM; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Hoogendoorn-Mulder PG; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Schokker RI; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Moerland MA; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Kroon PS; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Roesink JM; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Fajardo RD; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Van der Leij F; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Jürgenliemk-Schulz IM; Department of Radiotherapy, University Medical Center Utrecht, Utrecht, The Netherlands.
Tech Innov Patient Support Radiat Oncol ; 31: 100262, 2024 Sep.
Article en En | MEDLINE | ID: mdl-39224832
ABSTRACT

Introduction:

At our department we have a dedicated 1.5 Tesla MRI/HDR brachytherapy suite, which provides the possibility of repeated MRI scanning before, during and after applicator insertion and before and/or after irradiation for patients with advanced cervical cancer. In this study we analysed the effect of this adaptive workflow. We investigated the number of interventions, their impact on organ doses (OAR) and the respective dose differences between total prescribed and total delivered doses. Materials and

methods:

Seventy patients with locally advanced cervical cancer FIGO2009 stages IB-IVA, treated from June 2016 till August 2020, were retrospectively analysed. The standard brachytherapy schedule consisted of two applicator insertions and delivery of three or four HDR fractions.OARs were recontoured on the repeated MRI scans. The D2cm3 dose difference between total prescribed and total delivered dose for bladder, rectum, sigmoid and bowel were calculated.

Results:

In total 153 interventions were performed, 3 replacements of the applicator, 23 adaptations of needle positions, bladder filling was changed 74 times and repeated rectal degassing 53 times. The impact of the rectal interventions was on average -1.2 Gy EQD23. Dose differences between total delivered and total prescribed D2cm3 for bladder, rectum, sigmoid and bowel were -0.6, 0.3, 2.2 and -0.6 Gy EQD23, respectively.

Conclusions:

An MRI scanner integrated into the brachytherapy suite enables multiple interventions based on the scans before treatment planning and dose delivery. This allows for customized treatment according to the changing anatomy of the individual patient and a better estimation of the delivered dose.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Tech Innov Patient Support Radiat Oncol Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Tech Innov Patient Support Radiat Oncol Año: 2024 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido