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A Comparison of Organs at Risk Doses in Gyn Intracavitary Brachytherapy for Different Tandem Lengths and Bladder Volumes Publisher Pubmed



Siavashpour Z1 ; Aghamiri MR1 ; Jaberi R2 ; Zareakha N3 ; Manshadi HRD4 ; Kirisits C5 ; Sedaghat M6
Authors
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Authors Affiliations
  1. 1. Department of Medical Radiation Engineering, Shahid Beheshti University, Tehran, Iran
  2. 2. Department of Radiotherapy, Tehran University of Medical Science, Tehran, Iran
  3. 3. Department of Brachytherapy, Pars Hospital, Tehran, Iran
  4. 4. Department of Radiotherapy, Hafte Tir Hospital, Tehran, Iran
  5. 5. Department of Radiotherapy and Oncology, Comprehensive Cancer Center, Medical University of Vienna, Austria
  6. 6. Centre integre de cancerologie de la Monteregie (CICM), Charles LeMoyne Hospital, Greenfield Park, QC, Canada

Source: Journal of Applied Clinical Medical Physics Published:2016


Abstract

The purpose of this study was to investigate the concurrent effects of tandem length and bladder volume on dose to pelvic organs at risk (OARs) in HDR intracavitary brachytherapy treatment of cervical cancer. Twenty patients with locally advanced cervical cancer were selected for brachytherapy using Rotterdam applicators. The patients were CT scanned twice with empty and full bladder. Two treatment plans were prepared on each of the image sets. Patients were categorized into two groups; those treated with a tandem length of 4 cm or smaller (T ≤ 4 cm) and those with tandem length larger than 4 cm (T > 4 cm). Only one tandem tip angle of 30° was studied. Dose-volume histograms (DVHs) of OARs were calculated and compared. Bladder dose was significantly affected by both bladder volume and tandem physical length for T ≤ 4 cm. This was reflected on the values obtained for D2cm3, D1cm3, and D0.1cm3 for both empty and full bladder cases. When T > 4 cm, no correlation could be established between variations in bladder dose and bladder volume. Rectum dose was generally lower when the bladder was empty and T > 4 cm. Dose to sigmoid was increased when T > 4 cm; this increase was larger when the bladder was full. Our results suggest that, for tandems longer than 4 cm, keeping the bladder empty may reduce the dose to rectum and sigmoid. This is contrary to cases where a shorter than 4 cm tandem is used in which a full bladder (about 50-120 cm3) tends to result in a lower dose to rectum and sigmoid. Attention should be given to doses to sigmoid with long tandem lengths, as a larger tandem generally results in a larger dose to sigmoid.
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