open access

Vol 19, No 6 (2014)
Original research articles
Published online: 2014-11-01
Submitted: 2013-06-11
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Dosimetric comparison of MRI-based HDR brachytherapy and stereotactic radiotherapy in patients with advanced cervical cancer: A virtual brachytherapy study

Bretislav Otahal, Martin Dolezel, Jakub Cvek, Ondrej Simetka, Jaroslav Klat, Lukas Knybel, Lukas Molenda, Eva Skacelikova, Ales Hlavka, David Feltl
DOI: 10.1016/j.rpor.2014.04.005
·
Rep Pract Oncol Radiother 2014;19(6):399-404.

open access

Vol 19, No 6 (2014)
Original research articles
Published online: 2014-11-01
Submitted: 2013-06-11

Abstract

Aim

To evaluate the treatment plans of 3D image-guided brachytherapy (BT) and stereotactic robotic radiotherapy with online image guidance – CyberKnife (CK) in patients with locally advanced cervix cancer.

Methods and materials

Ten pairs of plans for patients with locally advanced inoperable cervical cancer were created using MR based 3D brachytherapy and stereotaxis CK. The dose that covers 98% of the target volume (HR CTV D98) was taken as a reference and other parameters were compared.

Results

Of the ten studied cases, the dose from D100 GTV was comparable for both devices, on average, the BT GTV D90 was 10–20% higher than for CK. The HR CTV D90 was higher for CK with an average difference of 10–20%, but only fifteen percent of HR CTV (the peripheral part) received a higher dose from CK, while 85% of the target volume received higher doses from BT. We found a significant organ-sparing effect of CK compared to brachytherapy (20–30% lower doses in 0.1[[ce:hsp sp="0.25"/]]cm3, 1[[ce:hsp sp="0.25"/]]cm3, and 2[[ce:hsp sp="0.25"/]]cm3).

Conclusion

BT remains to be the best method for dose escalation. Due to the significant organ-sparing effect of CK, patients that are not candidates for BT could benefit from stereotaxis more than from classical external beam radiotherapy.

Abstract

Aim

To evaluate the treatment plans of 3D image-guided brachytherapy (BT) and stereotactic robotic radiotherapy with online image guidance – CyberKnife (CK) in patients with locally advanced cervix cancer.

Methods and materials

Ten pairs of plans for patients with locally advanced inoperable cervical cancer were created using MR based 3D brachytherapy and stereotaxis CK. The dose that covers 98% of the target volume (HR CTV D98) was taken as a reference and other parameters were compared.

Results

Of the ten studied cases, the dose from D100 GTV was comparable for both devices, on average, the BT GTV D90 was 10–20% higher than for CK. The HR CTV D90 was higher for CK with an average difference of 10–20%, but only fifteen percent of HR CTV (the peripheral part) received a higher dose from CK, while 85% of the target volume received higher doses from BT. We found a significant organ-sparing effect of CK compared to brachytherapy (20–30% lower doses in 0.1[[ce:hsp sp="0.25"/]]cm3, 1[[ce:hsp sp="0.25"/]]cm3, and 2[[ce:hsp sp="0.25"/]]cm3).

Conclusion

BT remains to be the best method for dose escalation. Due to the significant organ-sparing effect of CK, patients that are not candidates for BT could benefit from stereotaxis more than from classical external beam radiotherapy.

Get Citation

Keywords

Brachytherapy; Cervix carcinoma; CyberKnife; Dosimetric study; Stereotactic radiotherapy

About this article
Title

Dosimetric comparison of MRI-based HDR brachytherapy and stereotactic radiotherapy in patients with advanced cervical cancer: A virtual brachytherapy study

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 19, No 6 (2014)

Pages

399-404

Published online

2014-11-01

DOI

10.1016/j.rpor.2014.04.005

Bibliographic record

Rep Pract Oncol Radiother 2014;19(6):399-404.

Keywords

Brachytherapy
Cervix carcinoma
CyberKnife
Dosimetric study
Stereotactic radiotherapy

Authors

Bretislav Otahal
Martin Dolezel
Jakub Cvek
Ondrej Simetka
Jaroslav Klat
Lukas Knybel
Lukas Molenda
Eva Skacelikova
Ales Hlavka
David Feltl

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