Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors
Abstract Background To evaluate the dosimetric performance of multi-channel vaginal cylinder (MCVC) against interstitial brachytherapy (ISBT) for the treatment of vaginal tumors. Methods Vaginal tumors with extension of > 0.5 cm and ≤ 2 cm from the lateral vaginal wall and/or ≤ 1 cm in height abo...
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doaj-dc5b167dda654914bcb7f9b85dde70452020-11-24T21:07:50ZengBMCRadiation Oncology1748-717X2017-05-011211510.1186/s13014-017-0821-0Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumorsLucas C. Mendez0Moti Paudel1Matt Wronski2Ananth Ravi3Lisa Barbera4Eric Leung5Odette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of TorontoOdette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medical Physics, University of TorontoOdette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medical Physics, University of TorontoOdette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Medical Physics, University of TorontoOdette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of TorontoOdette Cancer Centre, Sunnybrook Health Sciences Centre, Department of Radiation Oncology, University of TorontoAbstract Background To evaluate the dosimetric performance of multi-channel vaginal cylinder (MCVC) against interstitial brachytherapy (ISBT) for the treatment of vaginal tumors. Methods Vaginal tumors with extension of > 0.5 cm and ≤ 2 cm from the lateral vaginal wall and/or ≤ 1 cm in height above the vaginal vault were retrospectively selected from a ISBT registry trial database. The selected patients were treated with ISBT and targets included the intermediate (IRCTV) or high-risk (HRCTV) clinical target volumes. For technique comparison, a 35 mm MCVC was registered with the interstitial intra-vaginal cylinder. Bladder and rectum contours were transferred from the ISBT to the MCVC-BT plans. Vaginal mucosa was achieved by 3 mm uniform expansion from cylinder surface. Both the ISBT and MCVC-BT plans were optimized using the Inverse Planning Simulated Annealing optimization algorithm. After normalizing target D90 to 700 cGy, dose to organs at risk were measured and compared between ISBT and MCVC plans. Results Six interstitial patient plans met the inclusion criteria for this study. Four patients had vaginal primaries and two recurrent cancers in the vagina. Lower doses to bladder and rectum were seen with ISBT plans. In half of the MCVC plans, the rectal dose met the recommended constraints. For plans in which the rectal constraint was not met, the target volumes were abutting the rectum and had a cranial-caudal length ≥ 5 cm. Dose to vaginal mucosa was lower in ISBT plans directed to the HRCTVs, although no difference was seen in circumferential IRCTVs. Conclusions Overall, ISBT results in decreased dose to OARs as compared to MCVC. However, MCVC BT results in acceptable doses to OARs with possible improvement in vaginal doses for circumferential targets. Careful consideration to tumor geometry and location may help guide optimal techniques in vaginal tumor brachytherapy.http://link.springer.com/article/10.1186/s13014-017-0821-0Target VolumeVaginal VaultVaginal MucosaInterstitial BrachytherapyVaginal Tumor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Lucas C. Mendez Moti Paudel Matt Wronski Ananth Ravi Lisa Barbera Eric Leung |
spellingShingle |
Lucas C. Mendez Moti Paudel Matt Wronski Ananth Ravi Lisa Barbera Eric Leung Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors Radiation Oncology Target Volume Vaginal Vault Vaginal Mucosa Interstitial Brachytherapy Vaginal Tumor |
author_facet |
Lucas C. Mendez Moti Paudel Matt Wronski Ananth Ravi Lisa Barbera Eric Leung |
author_sort |
Lucas C. Mendez |
title |
Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
title_short |
Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
title_full |
Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
title_fullStr |
Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
title_full_unstemmed |
Dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
title_sort |
dosimetric comparison of interstitial brachytherapy with multi-channel vaginal cylinder plans in patients with vaginal tumors |
publisher |
BMC |
series |
Radiation Oncology |
issn |
1748-717X |
publishDate |
2017-05-01 |
description |
Abstract Background To evaluate the dosimetric performance of multi-channel vaginal cylinder (MCVC) against interstitial brachytherapy (ISBT) for the treatment of vaginal tumors. Methods Vaginal tumors with extension of > 0.5 cm and ≤ 2 cm from the lateral vaginal wall and/or ≤ 1 cm in height above the vaginal vault were retrospectively selected from a ISBT registry trial database. The selected patients were treated with ISBT and targets included the intermediate (IRCTV) or high-risk (HRCTV) clinical target volumes. For technique comparison, a 35 mm MCVC was registered with the interstitial intra-vaginal cylinder. Bladder and rectum contours were transferred from the ISBT to the MCVC-BT plans. Vaginal mucosa was achieved by 3 mm uniform expansion from cylinder surface. Both the ISBT and MCVC-BT plans were optimized using the Inverse Planning Simulated Annealing optimization algorithm. After normalizing target D90 to 700 cGy, dose to organs at risk were measured and compared between ISBT and MCVC plans. Results Six interstitial patient plans met the inclusion criteria for this study. Four patients had vaginal primaries and two recurrent cancers in the vagina. Lower doses to bladder and rectum were seen with ISBT plans. In half of the MCVC plans, the rectal dose met the recommended constraints. For plans in which the rectal constraint was not met, the target volumes were abutting the rectum and had a cranial-caudal length ≥ 5 cm. Dose to vaginal mucosa was lower in ISBT plans directed to the HRCTVs, although no difference was seen in circumferential IRCTVs. Conclusions Overall, ISBT results in decreased dose to OARs as compared to MCVC. However, MCVC BT results in acceptable doses to OARs with possible improvement in vaginal doses for circumferential targets. Careful consideration to tumor geometry and location may help guide optimal techniques in vaginal tumor brachytherapy. |
topic |
Target Volume Vaginal Vault Vaginal Mucosa Interstitial Brachytherapy Vaginal Tumor |
url |
http://link.springer.com/article/10.1186/s13014-017-0821-0 |
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