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The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation

PURPOSE: In advanced cervical cancers, improved techniques using both intracavitary and interstitial brachytherapy (IC + IS) should be used to adequately cover the residual tumor volume, resulting in better clinical results. Confronted with some limitation in implementing available applicators, we d...

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Autores principales: Banerjee, Susovan, Kaliyaperumal, Venkatesan, Kataria, Tejinder, Kamaraj, Dayanidhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073347/
https://www.ncbi.nlm.nih.gov/pubmed/32190069
http://dx.doi.org/10.5114/jcb.2020.92528
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author Banerjee, Susovan
Kaliyaperumal, Venkatesan
Kataria, Tejinder
Kamaraj, Dayanidhi
author_facet Banerjee, Susovan
Kaliyaperumal, Venkatesan
Kataria, Tejinder
Kamaraj, Dayanidhi
author_sort Banerjee, Susovan
collection PubMed
description PURPOSE: In advanced cervical cancers, improved techniques using both intracavitary and interstitial brachytherapy (IC + IS) should be used to adequately cover the residual tumor volume, resulting in better clinical results. Confronted with some limitation in implementing available applicators, we devised our own indigenous template that would also serve as an applicator. MATERIAL AND METHODS: First, a graphical design was drawn, keeping in mind the extent of volumes that need to be targeted in various brachytherapy scenarios. It was validated in a computer system and a physical template was manufactured. The template underwent modified versions through iterative dosimetric and planning exercises. The final model was successfully implemented in a clinical scenario. RESULTS: Cylindrical templates of diameter 3, 4, and 5 cm were produced with central aperture for central tandem, combining surrounding holes spaced at pre-planned points. The instrument can be used for IC + IS brachytherapy in cervical cancers. This easy to use applicator/template can direct needles to treat a distance of 4.5 cm laterally at the level of point A. In two initial applications 55 and 54 cc of high-risk clinical target volumes (HRCTV) were treated, and 90% of the HRCTV was covered by 96% and 97% of prescribed doses, respectively. Additionally, the needles guided by the template helped in sculpting the dose from bladder and rectum. CONCLUSIONS: We have developed an easy to use IC + IS type of template/applicator, which was successfully implemented in our clinical practice.
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spelling pubmed-70733472020-03-18 The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation Banerjee, Susovan Kaliyaperumal, Venkatesan Kataria, Tejinder Kamaraj, Dayanidhi J Contemp Brachytherapy Original Paper PURPOSE: In advanced cervical cancers, improved techniques using both intracavitary and interstitial brachytherapy (IC + IS) should be used to adequately cover the residual tumor volume, resulting in better clinical results. Confronted with some limitation in implementing available applicators, we devised our own indigenous template that would also serve as an applicator. MATERIAL AND METHODS: First, a graphical design was drawn, keeping in mind the extent of volumes that need to be targeted in various brachytherapy scenarios. It was validated in a computer system and a physical template was manufactured. The template underwent modified versions through iterative dosimetric and planning exercises. The final model was successfully implemented in a clinical scenario. RESULTS: Cylindrical templates of diameter 3, 4, and 5 cm were produced with central aperture for central tandem, combining surrounding holes spaced at pre-planned points. The instrument can be used for IC + IS brachytherapy in cervical cancers. This easy to use applicator/template can direct needles to treat a distance of 4.5 cm laterally at the level of point A. In two initial applications 55 and 54 cc of high-risk clinical target volumes (HRCTV) were treated, and 90% of the HRCTV was covered by 96% and 97% of prescribed doses, respectively. Additionally, the needles guided by the template helped in sculpting the dose from bladder and rectum. CONCLUSIONS: We have developed an easy to use IC + IS type of template/applicator, which was successfully implemented in our clinical practice. Termedia Publishing House 2020-02-28 2020-02 /pmc/articles/PMC7073347/ /pubmed/32190069 http://dx.doi.org/10.5114/jcb.2020.92528 Text en Copyright © 2020 Termedia 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 (http://creativecommons.org/licenses/by-nc-sa/4.0/)
spellingShingle Original Paper
Banerjee, Susovan
Kaliyaperumal, Venkatesan
Kataria, Tejinder
Kamaraj, Dayanidhi
The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title_full The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title_fullStr The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title_full_unstemmed The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title_short The Medanta AOLO template for locally advanced cancer cervix brachytherapy: design and clinical implementation
title_sort medanta aolo template for locally advanced cancer cervix brachytherapy: design and clinical implementation
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073347/
https://www.ncbi.nlm.nih.gov/pubmed/32190069
http://dx.doi.org/10.5114/jcb.2020.92528
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