Cargando…
The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer
PURPOSE: Radiotherapy with concurrent chemotherapy has been recommended as standard treatment for locally advanced cervical cancer. To validate the main tumor location before each high-precision helical tomotherapy (HT) fraction, the development of a more reliable marker or indicator is of clinical...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793067/ https://www.ncbi.nlm.nih.gov/pubmed/26985201 http://dx.doi.org/10.5114/jcb.2016.57803 |
_version_ | 1782421337303678976 |
---|---|
author | Jan, Ya-Ting Chang, Chih-Long Tai, Hung-Chi Huang, Yu-Chuen Liao, Chia-Ling Chen, Yu-Jen |
author_facet | Jan, Ya-Ting Chang, Chih-Long Tai, Hung-Chi Huang, Yu-Chuen Liao, Chia-Ling Chen, Yu-Jen |
author_sort | Jan, Ya-Ting |
collection | PubMed |
description | PURPOSE: Radiotherapy with concurrent chemotherapy has been recommended as standard treatment for locally advanced cervical cancer. To validate the main tumor location before each high-precision helical tomotherapy (HT) fraction, the development of a more reliable marker or indicator is of clinical importance to avoid inadequate coverage of the main tumor. MATERIAL AND METHODS: A 61-year-old woman with cervical cancer, TMN stage cT2b2N1M1, FIGO stage IVB was presented. Extended field external beam radiotherapy (EBRT) with concurrent chemotherapy and the interdigitated delivery of intracavitary brachytherapy was performed. Helical tomotherapy equipped with megavoltage cone beam computed tomography (MV-CBCT) was used for image-guided radiotherapy. For the insertion of tandem of brachytherapy applicator, a silicone sleeve with a central hollow canal was placed into the endocervical canal with the caudal end stopping at the outer surface of the cervical os, and making contact with the distal boundary of the cervical tumor during the entire brachytherapy course. RESULTS: In the remaining EBRT fractions, we found that the air cavity inside the central hollow canal of the sleeve could be clearly identified in daily CBCT images. The radiation oncologists matched the bony markers to adjust the daily setup errors because the megavoltage of the CBCT images could not provide a precise boundary between the soft tissue and the tumor, but the sleeve air cavity, with a clear boundary, could be used as a surrogate and reliable marker to guide the daily setup errors, and to demonstrate the primary tumor location before delivery of each HT fraction. CONCLUSIONS: The application of the sleeve during the interdigitated course of HT and brachytherapy in this patient provided information for the feasibility of using the sleeve air cavity as a surrogate marker for the localization of the main primary tumor before the daily delivery of image-guided HT. |
format | Online Article Text |
id | pubmed-4793067 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-47930672016-03-16 The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer Jan, Ya-Ting Chang, Chih-Long Tai, Hung-Chi Huang, Yu-Chuen Liao, Chia-Ling Chen, Yu-Jen J Contemp Brachytherapy Case Report PURPOSE: Radiotherapy with concurrent chemotherapy has been recommended as standard treatment for locally advanced cervical cancer. To validate the main tumor location before each high-precision helical tomotherapy (HT) fraction, the development of a more reliable marker or indicator is of clinical importance to avoid inadequate coverage of the main tumor. MATERIAL AND METHODS: A 61-year-old woman with cervical cancer, TMN stage cT2b2N1M1, FIGO stage IVB was presented. Extended field external beam radiotherapy (EBRT) with concurrent chemotherapy and the interdigitated delivery of intracavitary brachytherapy was performed. Helical tomotherapy equipped with megavoltage cone beam computed tomography (MV-CBCT) was used for image-guided radiotherapy. For the insertion of tandem of brachytherapy applicator, a silicone sleeve with a central hollow canal was placed into the endocervical canal with the caudal end stopping at the outer surface of the cervical os, and making contact with the distal boundary of the cervical tumor during the entire brachytherapy course. RESULTS: In the remaining EBRT fractions, we found that the air cavity inside the central hollow canal of the sleeve could be clearly identified in daily CBCT images. The radiation oncologists matched the bony markers to adjust the daily setup errors because the megavoltage of the CBCT images could not provide a precise boundary between the soft tissue and the tumor, but the sleeve air cavity, with a clear boundary, could be used as a surrogate and reliable marker to guide the daily setup errors, and to demonstrate the primary tumor location before delivery of each HT fraction. CONCLUSIONS: The application of the sleeve during the interdigitated course of HT and brachytherapy in this patient provided information for the feasibility of using the sleeve air cavity as a surrogate marker for the localization of the main primary tumor before the daily delivery of image-guided HT. Termedia Publishing House 2016-02-08 2016-02 /pmc/articles/PMC4793067/ /pubmed/26985201 http://dx.doi.org/10.5114/jcb.2016.57803 Text en Copyright © 2016 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Case Report Jan, Ya-Ting Chang, Chih-Long Tai, Hung-Chi Huang, Yu-Chuen Liao, Chia-Ling Chen, Yu-Jen The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title | The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title_full | The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title_fullStr | The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title_full_unstemmed | The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title_short | The air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
title_sort | air matters – sleeve air cavity as a marker guiding image-guided helical tomotherapy to target cervical cancer |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793067/ https://www.ncbi.nlm.nih.gov/pubmed/26985201 http://dx.doi.org/10.5114/jcb.2016.57803 |
work_keys_str_mv | AT janyating theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT changchihlong theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT taihungchi theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT huangyuchuen theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT liaochialing theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT chenyujen theairmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT janyating airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT changchihlong airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT taihungchi airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT huangyuchuen airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT liaochialing airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer AT chenyujen airmatterssleeveaircavityasamarkerguidingimageguidedhelicaltomotherapytotargetcervicalcancer |