Inverse planning for combination of intracavitary and interstitial brachytherapy for locally advanced cervical cancer

Kotaro Yoshio, Naoya Murakami, Madoka Morota, Ken Harada, Mayuka Kitaguchi, Kentaro Yamagishi, Shuhei Sekii, Kana Takahashi, Koji Inaba, Hiroshi Mayahara, Yoshinori Ito, Minako Sumi, Jun Itami, Susumu Kanazawa

    Research output: Contribution to journalArticlepeer-review

    14 Citations (Scopus)

    Abstract

    The main purpose of this study was to compare three different treatment plans for locally advanced cervical cancer: (1) the inverse-planning simulated annealing (IPSA) plan for combination brachytherapy (BT) of interstitial and intracavitary brachytherapy, (2) manual optimization based on the Manchester system for combination-BT, and (3) the conventional Manchester system using only tandem and ovoids. This was a retrospective study of 25 consecutive implants. The high-risk clinical target volume (HR-CTV) and organs at risk were defined according to the GEC-ESTRO Working Group definitions. A dose of 6 Gy was prescribed. The uniform cost function for dose constraints was applied to all IPSA-generated plans. The coverage of the HR-CTV by IPSA for combination-BT was equivalent to that of manual optimization, and was better than that of the Manchester system using only tandem and ovoids. The mean V100 achieved by IPSA for combination-BT, manual optimization and Manchester was 96 ± 3.7%, 95 ± 5.5% and 80 ± 13.4%, respectively. The mean D100 was 483 ± 80, 487 ± 97 and 335 ± 119 cGy, respectively. The mean D90 was 677 ± 61, 681 ± 88 and 513 ± 150 cGy, respectively. IPSA resulted in significant reductions of the doses to the rectum (IPSA D2cm3: 408 ± 71 cGy vs manual optimization D2cm3: 485 ± 105 cGy; P = 0.03) and the bladder (IPSA D2cm3: 452 ± 60 cGy vs manual optimization D2cm3: 583 ± 113 cGy; P < 0.0001). In conclusion, combination-BT achieved better tumor coverage, and plans using IPSA provided significant sparing of normal tissues without compromising CTV coverage.

    Original languageEnglish
    Pages (from-to)1146-1152
    Number of pages7
    JournalJournal of radiation research
    Volume54
    Issue number6
    DOIs
    Publication statusPublished - Nov 2013

    Keywords

    • Cervical cancer
    • Combination brachytherapy
    • HDR
    • IPSA
    • Optimize

    ASJC Scopus subject areas

    • Radiation
    • Radiology Nuclear Medicine and imaging
    • Health, Toxicology and Mutagenesis

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