Дозиметрическая оценка различных методик сочетанной лучевой терапии больных раком шейки матки = Dosimetric evaluation for various methods of combined radiotherapy of cervical cancer

Translated title of the contribution: Dosimetric evaluation for various methods of combined radiotherapy of cervical cancer

S. Sukhikh, L. G. Sukhikh, Yu Anikeeva, P. V. Izhevsky, I. N. Sheino

Research output: Contribution to journalArticle

Abstract

Purpose: Carrying out dosimetric investigation of possibility to replace a traditional combined radiation therapy of cervical cancer by combinations only external irradiation, without change of total course dose and number of fractions. Material and Methods: Eleven patients with a diagnosis of cervical cancer (stages T 2b N x M 0 and T 3 N x M 0 ) who received a course of combined radiotherapy (CRT) have been considered in this study. The combination of dose delivery techniques 3D-CRT + high dose rate brachytherapy (HDR) was used as a basic one. The following fractionation regimes for CRT were simulated: external beam RT (EBRT) of the first stage – total dose 50 Gy and fraction dose 2 Gy (25 fractions), the second stage – total dose 28 Gy and fraction dose 7 Gy (4 fractions). Total CRT course dose was 89.7 Gy EQD 2 . Dosimetric planning of EBRT using conventional radiography and 3D-CRT has been carried out using XIO dosimetry planning system. Dosimetric planning of first-stage EBRT and second-stage EBRT using the VMAT technique has been performed in the Monaco dosimetry planning system. HDR of the second stage has been planned using the HDRplus dosimetric planning system for the Multisource HDR unit with a 60 Co source. Results: Coverage of the clinical volume of the tumor using HDR, on average, was equal to 95 % of the prescribed dose at 91.8 % of the volume, 110 % of the dose – 75.7 % of the volume. 60 Co + VMAT results in the coverage level 95 % of the dose at 97.1 % of the volume and 110 % of the dose at 2.1 % of the volume. 3D-CRT + VMAT provide the coverage level of 95 % of the dose at 98 % of the volume and 110 % of the dose at 2.6 % of the volume. Using the combination VMAT + VMAT allows achieving the average coverage of the target at the level of 98 % of the dose at 97 % of the volume, 110 % of the dose at 8.8 % of the volume. The maximum dose per volume of the organs at risk equal to 2 cm 3 did not exceed their tolerant levels both for the bladder and for the rectum. Conclusion: At present, there is a technical possibility to replace the second stage of CRT cervical cancer by EBRT using the VMAT technique. Implementation of the VMAT technique allows to increase the uniformity of irradiated volume coverage comparing with traditional HDR. While using VMAT technique the tolerant levels of organs at risk are not exceeded.

Original languageRussian
Pages (from-to)45-52
Number of pages8
JournalMedical Radiology and Radiation Safety
Volume64
Issue number1
DOIs
Publication statusPublished - 1 Jan 2019

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Uterine Cervical Neoplasms
Radiotherapy
Brachytherapy
Organs at Risk
Monaco
Tumor Burden
Rectum
Radiography
Urinary Bladder

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{452de7a167464bf39574e576dde7e32e,
title = "Дозиметрическая оценка различных методик сочетанной лучевой терапии больных раком шейки матки = Dosimetric evaluation for various methods of combined radiotherapy of cervical cancer",
abstract = "Purpose: Carrying out dosimetric investigation of possibility to replace a traditional combined radiation therapy of cervical cancer by combinations only external irradiation, without change of total course dose and number of fractions. Material and Methods: Eleven patients with a diagnosis of cervical cancer (stages T 2b N x M 0 and T 3 N x M 0 ) who received a course of combined radiotherapy (CRT) have been considered in this study. The combination of dose delivery techniques 3D-CRT + high dose rate brachytherapy (HDR) was used as a basic one. The following fractionation regimes for CRT were simulated: external beam RT (EBRT) of the first stage – total dose 50 Gy and fraction dose 2 Gy (25 fractions), the second stage – total dose 28 Gy and fraction dose 7 Gy (4 fractions). Total CRT course dose was 89.7 Gy EQD 2 . Dosimetric planning of EBRT using conventional radiography and 3D-CRT has been carried out using XIO dosimetry planning system. Dosimetric planning of first-stage EBRT and second-stage EBRT using the VMAT technique has been performed in the Monaco dosimetry planning system. HDR of the second stage has been planned using the HDRplus dosimetric planning system for the Multisource HDR unit with a 60 Co source. Results: Coverage of the clinical volume of the tumor using HDR, on average, was equal to 95 {\%} of the prescribed dose at 91.8 {\%} of the volume, 110 {\%} of the dose – 75.7 {\%} of the volume. 60 Co + VMAT results in the coverage level 95 {\%} of the dose at 97.1 {\%} of the volume and 110 {\%} of the dose at 2.1 {\%} of the volume. 3D-CRT + VMAT provide the coverage level of 95 {\%} of the dose at 98 {\%} of the volume and 110 {\%} of the dose at 2.6 {\%} of the volume. Using the combination VMAT + VMAT allows achieving the average coverage of the target at the level of 98 {\%} of the dose at 97 {\%} of the volume, 110 {\%} of the dose at 8.8 {\%} of the volume. The maximum dose per volume of the organs at risk equal to 2 cm 3 did not exceed their tolerant levels both for the bladder and for the rectum. Conclusion: At present, there is a technical possibility to replace the second stage of CRT cervical cancer by EBRT using the VMAT technique. Implementation of the VMAT technique allows to increase the uniformity of irradiated volume coverage comparing with traditional HDR. While using VMAT technique the tolerant levels of organs at risk are not exceeded.",
keywords = "Brachytherapy, Cervical cancer, Combined radiotherapy, Dosimetric evaluation, External beam radiation therapy",
author = "S. Sukhikh and Sukhikh, {L. G.} and Yu Anikeeva and Izhevsky, {P. V.} and Sheino, {I. N.}",
year = "2019",
month = "1",
day = "1",
doi = "10.12737/article_5c55fb4a074ee1.27347494",
language = "Русский",
volume = "64",
pages = "45--52",
journal = "Medical Radiology and Radiation Safety",
issn = "1024-6177",
publisher = "State Research Center, Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency",
number = "1",

}

TY - JOUR

T1 - Дозиметрическая оценка различных методик сочетанной лучевой терапии больных раком шейки матки = Dosimetric evaluation for various methods of combined radiotherapy of cervical cancer

AU - Sukhikh, S.

AU - Sukhikh, L. G.

AU - Anikeeva, Yu

AU - Izhevsky, P. V.

AU - Sheino, I. N.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Purpose: Carrying out dosimetric investigation of possibility to replace a traditional combined radiation therapy of cervical cancer by combinations only external irradiation, without change of total course dose and number of fractions. Material and Methods: Eleven patients with a diagnosis of cervical cancer (stages T 2b N x M 0 and T 3 N x M 0 ) who received a course of combined radiotherapy (CRT) have been considered in this study. The combination of dose delivery techniques 3D-CRT + high dose rate brachytherapy (HDR) was used as a basic one. The following fractionation regimes for CRT were simulated: external beam RT (EBRT) of the first stage – total dose 50 Gy and fraction dose 2 Gy (25 fractions), the second stage – total dose 28 Gy and fraction dose 7 Gy (4 fractions). Total CRT course dose was 89.7 Gy EQD 2 . Dosimetric planning of EBRT using conventional radiography and 3D-CRT has been carried out using XIO dosimetry planning system. Dosimetric planning of first-stage EBRT and second-stage EBRT using the VMAT technique has been performed in the Monaco dosimetry planning system. HDR of the second stage has been planned using the HDRplus dosimetric planning system for the Multisource HDR unit with a 60 Co source. Results: Coverage of the clinical volume of the tumor using HDR, on average, was equal to 95 % of the prescribed dose at 91.8 % of the volume, 110 % of the dose – 75.7 % of the volume. 60 Co + VMAT results in the coverage level 95 % of the dose at 97.1 % of the volume and 110 % of the dose at 2.1 % of the volume. 3D-CRT + VMAT provide the coverage level of 95 % of the dose at 98 % of the volume and 110 % of the dose at 2.6 % of the volume. Using the combination VMAT + VMAT allows achieving the average coverage of the target at the level of 98 % of the dose at 97 % of the volume, 110 % of the dose at 8.8 % of the volume. The maximum dose per volume of the organs at risk equal to 2 cm 3 did not exceed their tolerant levels both for the bladder and for the rectum. Conclusion: At present, there is a technical possibility to replace the second stage of CRT cervical cancer by EBRT using the VMAT technique. Implementation of the VMAT technique allows to increase the uniformity of irradiated volume coverage comparing with traditional HDR. While using VMAT technique the tolerant levels of organs at risk are not exceeded.

AB - Purpose: Carrying out dosimetric investigation of possibility to replace a traditional combined radiation therapy of cervical cancer by combinations only external irradiation, without change of total course dose and number of fractions. Material and Methods: Eleven patients with a diagnosis of cervical cancer (stages T 2b N x M 0 and T 3 N x M 0 ) who received a course of combined radiotherapy (CRT) have been considered in this study. The combination of dose delivery techniques 3D-CRT + high dose rate brachytherapy (HDR) was used as a basic one. The following fractionation regimes for CRT were simulated: external beam RT (EBRT) of the first stage – total dose 50 Gy and fraction dose 2 Gy (25 fractions), the second stage – total dose 28 Gy and fraction dose 7 Gy (4 fractions). Total CRT course dose was 89.7 Gy EQD 2 . Dosimetric planning of EBRT using conventional radiography and 3D-CRT has been carried out using XIO dosimetry planning system. Dosimetric planning of first-stage EBRT and second-stage EBRT using the VMAT technique has been performed in the Monaco dosimetry planning system. HDR of the second stage has been planned using the HDRplus dosimetric planning system for the Multisource HDR unit with a 60 Co source. Results: Coverage of the clinical volume of the tumor using HDR, on average, was equal to 95 % of the prescribed dose at 91.8 % of the volume, 110 % of the dose – 75.7 % of the volume. 60 Co + VMAT results in the coverage level 95 % of the dose at 97.1 % of the volume and 110 % of the dose at 2.1 % of the volume. 3D-CRT + VMAT provide the coverage level of 95 % of the dose at 98 % of the volume and 110 % of the dose at 2.6 % of the volume. Using the combination VMAT + VMAT allows achieving the average coverage of the target at the level of 98 % of the dose at 97 % of the volume, 110 % of the dose at 8.8 % of the volume. The maximum dose per volume of the organs at risk equal to 2 cm 3 did not exceed their tolerant levels both for the bladder and for the rectum. Conclusion: At present, there is a technical possibility to replace the second stage of CRT cervical cancer by EBRT using the VMAT technique. Implementation of the VMAT technique allows to increase the uniformity of irradiated volume coverage comparing with traditional HDR. While using VMAT technique the tolerant levels of organs at risk are not exceeded.

KW - Brachytherapy

KW - Cervical cancer

KW - Combined radiotherapy

KW - Dosimetric evaluation

KW - External beam radiation therapy

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U2 - 10.12737/article_5c55fb4a074ee1.27347494

DO - 10.12737/article_5c55fb4a074ee1.27347494

M3 - Статья

VL - 64

SP - 45

EP - 52

JO - Medical Radiology and Radiation Safety

JF - Medical Radiology and Radiation Safety

SN - 1024-6177

IS - 1

ER -