open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2018-05-31
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Dose to pelvic lymph nodes in image based high dose rate brachytherapy of carcinoma cervix

Ramya Rangarajan, Saravanan Subramanian, Kalyani Gopalakrishnan, Vijayalakshmi Jothi, Kumari Krishnamurthy
DOI: 10.1016/j.rpor.2018.10.005
·
Rep Pract Oncol Radiother 2019;24(1):80-85.

open access

Vol 24, No 1 (2019)
Original research articles
Published online: 2019-01-01
Submitted: 2018-05-31

Abstract

Aim

The aim of this study is to analyse the dosimetry to the pelvic lymph nodes and its correlation to point B using CT based high dose rate brachytherapy of carcinoma cervix.

Background

Conventionally, dose to pelvic lymph nodes from intracavitary brachytherapy was reported by point B and by the reference points of the lymphatic trapezoid.

Materials and methods

30 consecutive CT based high dose rate applications were reviewed between February and March 2016. The high risk clinical target volume and the organs at risk and the pelvic nodal groups were contoured. DVH parameters for the right and left obturator nodal group, right and left external iliac nodal group and right and left internal iliac nodal group were recorded. Right and left point B doses were also recorded.

Results

On analysis of the combined dose, it was found that all the DVH parameters were significantly different from point B, except the D100 obturator and D2cc internal iliac lymph node. There was a significant correlation between all DVH parameters and point B, except D2cc, D1cc and D0.1cc of external iliac. The obturator group received the highest dose contribution from brachytherapy. The mean D90 dose received per fraction for the obturator, external iliac and internal iliac nodes was 2.7Gy, 1.17Gy and 1.41Gy, respectively.

Conclusions

There is a significant dose contribution to the pelvic lymph nodal groups during intracavitary brachytherapy. There is a low degree of correlation between point B dose and dosimetric parameters of the individual nodal groups. Hence, it is important to analyse the dose delivered to individual nodal groups during intracavitary brachytherapy, at least in patients with enlarged lymph nodes to calculate the cumulative dose delivered.

Abstract

Aim

The aim of this study is to analyse the dosimetry to the pelvic lymph nodes and its correlation to point B using CT based high dose rate brachytherapy of carcinoma cervix.

Background

Conventionally, dose to pelvic lymph nodes from intracavitary brachytherapy was reported by point B and by the reference points of the lymphatic trapezoid.

Materials and methods

30 consecutive CT based high dose rate applications were reviewed between February and March 2016. The high risk clinical target volume and the organs at risk and the pelvic nodal groups were contoured. DVH parameters for the right and left obturator nodal group, right and left external iliac nodal group and right and left internal iliac nodal group were recorded. Right and left point B doses were also recorded.

Results

On analysis of the combined dose, it was found that all the DVH parameters were significantly different from point B, except the D100 obturator and D2cc internal iliac lymph node. There was a significant correlation between all DVH parameters and point B, except D2cc, D1cc and D0.1cc of external iliac. The obturator group received the highest dose contribution from brachytherapy. The mean D90 dose received per fraction for the obturator, external iliac and internal iliac nodes was 2.7Gy, 1.17Gy and 1.41Gy, respectively.

Conclusions

There is a significant dose contribution to the pelvic lymph nodal groups during intracavitary brachytherapy. There is a low degree of correlation between point B dose and dosimetric parameters of the individual nodal groups. Hence, it is important to analyse the dose delivered to individual nodal groups during intracavitary brachytherapy, at least in patients with enlarged lymph nodes to calculate the cumulative dose delivered.

Get Citation

Keywords

Lymph node dose; Intracavitary brachytherapy; CT based planning

About this article
Title

Dose to pelvic lymph nodes in image based high dose rate brachytherapy of carcinoma cervix

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 24, No 1 (2019)

Pages

80-85

Published online

2019-01-01

DOI

10.1016/j.rpor.2018.10.005

Bibliographic record

Rep Pract Oncol Radiother 2019;24(1):80-85.

Keywords

Lymph node dose
Intracavitary brachytherapy
CT based planning

Authors

Ramya Rangarajan
Saravanan Subramanian
Kalyani Gopalakrishnan
Vijayalakshmi Jothi
Kumari Krishnamurthy

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