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Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study

PURPOSE: The aim of this study is to compare 3D dose volume histogram (DVH) parameters of bladder and other organs at risk with different bladder filling protocol during high-dose-rate intracavitary brachytherapy (HDR-ICBT) in cervical cancer, and to find optimized bladder volume. MATERIAL AND METHO...

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Autores principales: Mahantshetty, Umesh, Shetty, Saurabha, Majumder, Dipanjan, Adurkar, Pranjal, Swamidas, Jamema, Engineer, Reena, Chopra, Supriya, Shrivastava, Shyamkishore
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437088/
https://www.ncbi.nlm.nih.gov/pubmed/28533798
http://dx.doi.org/10.5114/jcb.2017.67502
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author Mahantshetty, Umesh
Shetty, Saurabha
Majumder, Dipanjan
Adurkar, Pranjal
Swamidas, Jamema
Engineer, Reena
Chopra, Supriya
Shrivastava, Shyamkishore
author_facet Mahantshetty, Umesh
Shetty, Saurabha
Majumder, Dipanjan
Adurkar, Pranjal
Swamidas, Jamema
Engineer, Reena
Chopra, Supriya
Shrivastava, Shyamkishore
author_sort Mahantshetty, Umesh
collection PubMed
description PURPOSE: The aim of this study is to compare 3D dose volume histogram (DVH) parameters of bladder and other organs at risk with different bladder filling protocol during high-dose-rate intracavitary brachytherapy (HDR-ICBT) in cervical cancer, and to find optimized bladder volume. MATERIAL AND METHODS: This dosimetric study was completed with 21 patients who underwent HDR-ICBT with computed tomography/magnetic resonance compatible applicator as a routine treatment. Computed tomography planning was done for each patient with bladder emptied (series 1), after 50 ml (series 2), and 100 ml (series 3) bladder filling with a saline infusion through the bladder catheter. Contouring was done on the Eclipse Planning System. 7 Gy to point A was prescribed with the standard loading patterns. Various 3D DVH parameters including 0.1 cc, 1 cc, 2 cc doses and mean doses to the OAR’s were noted. Paired t-test was performed. RESULTS: The mean (± SD) bladder volume was 64.5 (± 25) cc, 116.2 (± 28) cc, and 172.9 (± 29) cc, for series 1, 2, and 3, respectively. The 0.1 cm(3),1 cm(3), 2 cm(3) mean bladder doses for series 1, series 2, and series 3 were 9.28 ± 2.27 Gy, 7.38 ± 1.72 Gy, 6.58 ± 1.58 Gy; 9.39 ± 2.28 Gy, 7.85 ± 1.85 Gy, 7.05 ± 1.59 Gy, and 10.09 ± 2.46 Gy, 8.33 ± 1.75 Gy, 7.6 ± 1.55 Gy, respectively. However, there was a trend towards higher bladder doses in series 3. Similarly, for small bowel dose 0.1 cm(3), 1 cm(3), and 2 cm(3) in series 1, 2, and 3 were 5.44 ± 2.2 Gy, 4.41 ± 1.84 Gy, 4 ± 1.69 Gy; 4.57 ± 2.89 Gy, 3.78 ± 2.21 Gy, 3.35 ± 2.02 Gy, and 4.09 ± 2.38 Gy, 3.26 ± 1.8 Gy, 3.05 ± 1.58 Gy. Significant increase in small bowel dose in empty bladder (series 1) compared to full bladder (series 3) (p = 0.03) was noted. However, the rectal and sigmoid doses were not significantly affected with either series. CONCLUSIONS: Bladder filling protocol with 50 ml and 100 ml was well tolerated and achieved a reasonably reproducible bladder volume during cervical brachytherapy. In our analysis so far, there is no significant impact of bladder filling on DVH parameters, although larger bladders tend to have higher doses. Small bowel doses are lesser with higher bladder volumes. Further evaluation and validation are necessary.
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spelling pubmed-54370882017-05-22 Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study Mahantshetty, Umesh Shetty, Saurabha Majumder, Dipanjan Adurkar, Pranjal Swamidas, Jamema Engineer, Reena Chopra, Supriya Shrivastava, Shyamkishore J Contemp Brachytherapy Original Paper PURPOSE: The aim of this study is to compare 3D dose volume histogram (DVH) parameters of bladder and other organs at risk with different bladder filling protocol during high-dose-rate intracavitary brachytherapy (HDR-ICBT) in cervical cancer, and to find optimized bladder volume. MATERIAL AND METHODS: This dosimetric study was completed with 21 patients who underwent HDR-ICBT with computed tomography/magnetic resonance compatible applicator as a routine treatment. Computed tomography planning was done for each patient with bladder emptied (series 1), after 50 ml (series 2), and 100 ml (series 3) bladder filling with a saline infusion through the bladder catheter. Contouring was done on the Eclipse Planning System. 7 Gy to point A was prescribed with the standard loading patterns. Various 3D DVH parameters including 0.1 cc, 1 cc, 2 cc doses and mean doses to the OAR’s were noted. Paired t-test was performed. RESULTS: The mean (± SD) bladder volume was 64.5 (± 25) cc, 116.2 (± 28) cc, and 172.9 (± 29) cc, for series 1, 2, and 3, respectively. The 0.1 cm(3),1 cm(3), 2 cm(3) mean bladder doses for series 1, series 2, and series 3 were 9.28 ± 2.27 Gy, 7.38 ± 1.72 Gy, 6.58 ± 1.58 Gy; 9.39 ± 2.28 Gy, 7.85 ± 1.85 Gy, 7.05 ± 1.59 Gy, and 10.09 ± 2.46 Gy, 8.33 ± 1.75 Gy, 7.6 ± 1.55 Gy, respectively. However, there was a trend towards higher bladder doses in series 3. Similarly, for small bowel dose 0.1 cm(3), 1 cm(3), and 2 cm(3) in series 1, 2, and 3 were 5.44 ± 2.2 Gy, 4.41 ± 1.84 Gy, 4 ± 1.69 Gy; 4.57 ± 2.89 Gy, 3.78 ± 2.21 Gy, 3.35 ± 2.02 Gy, and 4.09 ± 2.38 Gy, 3.26 ± 1.8 Gy, 3.05 ± 1.58 Gy. Significant increase in small bowel dose in empty bladder (series 1) compared to full bladder (series 3) (p = 0.03) was noted. However, the rectal and sigmoid doses were not significantly affected with either series. CONCLUSIONS: Bladder filling protocol with 50 ml and 100 ml was well tolerated and achieved a reasonably reproducible bladder volume during cervical brachytherapy. In our analysis so far, there is no significant impact of bladder filling on DVH parameters, although larger bladders tend to have higher doses. Small bowel doses are lesser with higher bladder volumes. Further evaluation and validation are necessary. Termedia Publishing House 2017-04-30 2017-04 /pmc/articles/PMC5437088/ /pubmed/28533798 http://dx.doi.org/10.5114/jcb.2017.67502 Text en Copyright: © 2017 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 Paper
Mahantshetty, Umesh
Shetty, Saurabha
Majumder, Dipanjan
Adurkar, Pranjal
Swamidas, Jamema
Engineer, Reena
Chopra, Supriya
Shrivastava, Shyamkishore
Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title_full Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title_fullStr Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title_full_unstemmed Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title_short Optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
title_sort optimal bladder filling during high-dose-rate intracavitary brachytherapy for cervical cancer: a dosimetric study
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5437088/
https://www.ncbi.nlm.nih.gov/pubmed/28533798
http://dx.doi.org/10.5114/jcb.2017.67502
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