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A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer

PURPOSE: In cervical intracavitary brachytherapy, it is mandatory to evaluate if the doses to bladder and rectum are within tolerance limits. In this study, an effort has been made to evaluate the effect of respiration on the doses to bladder and rectum in patients undergoing brachytherapy. MATERIAL...

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Autores principales: Prabhakar, Ramachandran, Jagadesan, Pandjatcharam, Haresh, Kunhi P, Karuna, Singh, Julka, Pramod Kumar, Rath, Goura Kishor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5183644/
https://www.ncbi.nlm.nih.gov/pubmed/28031739
http://dx.doi.org/10.5114/jcb.2010.13719
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author Prabhakar, Ramachandran
Jagadesan, Pandjatcharam
Haresh, Kunhi P
Karuna, Singh
Julka, Pramod Kumar
Rath, Goura Kishor
author_facet Prabhakar, Ramachandran
Jagadesan, Pandjatcharam
Haresh, Kunhi P
Karuna, Singh
Julka, Pramod Kumar
Rath, Goura Kishor
author_sort Prabhakar, Ramachandran
collection PubMed
description PURPOSE: In cervical intracavitary brachytherapy, it is mandatory to evaluate if the doses to bladder and rectum are within tolerance limits. In this study, an effort has been made to evaluate the effect of respiration on the doses to bladder and rectum in patients undergoing brachytherapy. MATERIAL AND METHODS: Fifteen patients with cervix cancer treated with concurrent chemoradiation followed by intracavitary brachytherapy were included in this study. At the time of brachytherapy, all patients underwent 4D computed tomography (CT) imaging. Five out of fifteen patients were scanned with empty bladder while the rest had full bladder during sectional imaging. Four sets of pelvic CT image datasets with applicators in place were acquired at equal interval in a complete respiratory cycle. Treatment plans were generated for all the CT datasets on a PlatoTM Sunrise planning system. A dose of 7 Gy was prescribed to Point A. Doses to ICRU (Report No.38) bladder (IBRP) and rectal (IRRP) reference points were calculated in all the CT datasets. RESULTS: The mean of maximum dose to IBRP at four different respiratory phases for full and empty bladder were 53.38 ± 19.20%, 55.75 ± 16.71%, 56.13 ± 17.70%, 57.50 ± 17.48% and 60.93 ± 15.18%, 60.29 ± 16.28%, 60.86 ± 15.90%, 60.82 ± 15.42% of the prescribed dose respectively. Similarly, maximum dose to IRRP for full and empty bladder were 55.50 ± 18.66%, 57.38 ± 14.81%, 58.00 ± 14.97%, 58.38 ± 17.28% and 71.96 ± 6.90%, 71.58 ± 7.52%, 68.92 ± 6.21%, 71.45 ± 7.16% respectively. CONCLUSIONS: Our study shows that respiration affects the dose distribution to the bladder and rectum in intracavitary brachytherapy of cervix cancer. It is advisable to reduce the critical organ dose to account for the dose variation introduced by respiratory motion.
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spelling pubmed-51836442016-12-28 A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer Prabhakar, Ramachandran Jagadesan, Pandjatcharam Haresh, Kunhi P Karuna, Singh Julka, Pramod Kumar Rath, Goura Kishor J Contemp Brachytherapy Original Article PURPOSE: In cervical intracavitary brachytherapy, it is mandatory to evaluate if the doses to bladder and rectum are within tolerance limits. In this study, an effort has been made to evaluate the effect of respiration on the doses to bladder and rectum in patients undergoing brachytherapy. MATERIAL AND METHODS: Fifteen patients with cervix cancer treated with concurrent chemoradiation followed by intracavitary brachytherapy were included in this study. At the time of brachytherapy, all patients underwent 4D computed tomography (CT) imaging. Five out of fifteen patients were scanned with empty bladder while the rest had full bladder during sectional imaging. Four sets of pelvic CT image datasets with applicators in place were acquired at equal interval in a complete respiratory cycle. Treatment plans were generated for all the CT datasets on a PlatoTM Sunrise planning system. A dose of 7 Gy was prescribed to Point A. Doses to ICRU (Report No.38) bladder (IBRP) and rectal (IRRP) reference points were calculated in all the CT datasets. RESULTS: The mean of maximum dose to IBRP at four different respiratory phases for full and empty bladder were 53.38 ± 19.20%, 55.75 ± 16.71%, 56.13 ± 17.70%, 57.50 ± 17.48% and 60.93 ± 15.18%, 60.29 ± 16.28%, 60.86 ± 15.90%, 60.82 ± 15.42% of the prescribed dose respectively. Similarly, maximum dose to IRRP for full and empty bladder were 55.50 ± 18.66%, 57.38 ± 14.81%, 58.00 ± 14.97%, 58.38 ± 17.28% and 71.96 ± 6.90%, 71.58 ± 7.52%, 68.92 ± 6.21%, 71.45 ± 7.16% respectively. CONCLUSIONS: Our study shows that respiration affects the dose distribution to the bladder and rectum in intracavitary brachytherapy of cervix cancer. It is advisable to reduce the critical organ dose to account for the dose variation introduced by respiratory motion. Termedia Publishing House 2010-04-01 2010-03 /pmc/articles/PMC5183644/ /pubmed/28031739 http://dx.doi.org/10.5114/jcb.2010.13719 Text en Copyright: © 2010 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 Original Article
Prabhakar, Ramachandran
Jagadesan, Pandjatcharam
Haresh, Kunhi P
Karuna, Singh
Julka, Pramod Kumar
Rath, Goura Kishor
A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title_full A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title_fullStr A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title_full_unstemmed A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title_short A study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
title_sort study on the variation of bladder and rectal doses with respiration in intracavitary brachytherapy for cervix cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5183644/
https://www.ncbi.nlm.nih.gov/pubmed/28031739
http://dx.doi.org/10.5114/jcb.2010.13719
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