The Gulf journal of oncology · 2025
Impact of size of ovoids with Intra-cavitary Brachytherapy on dose to point A in patients with Cancer Cervix.
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Pasha Tanvir, Radhakrishna Nikhila, Buchapudi Rekha Reddy, Pullan Saritha Sunny, S Hamsini R, Jerod Elna, Thimmaiah Naveen, Poojar Sridhar, Krishna Uday, Palled Siddanna Rudrappa, B Thejaswini, Viswanath Lokesh
Аннотация
BACKGROUND: Intracavitary Brachytherapy(ICBT) applications alone offer suboptimal coverage in some patients with medial parametrial(<2cms) residual disease after optimization. This retrospective study aims to identify the commonly accommodated size of ovoids in ICBT to identify the dose delivered to the parametrial disease and organs at risk (OARs).
METHODS: Cancer cervix Patients treated with concurrent chemoradiotherapy and High Dose Rate(HDR) BT of 6-7 Gy in 3-4 fractions prescribed to point A were identified. Dosimetric details were documented from BT plans.
RESULTS: 219 ICBT applications were performed for 142 patients. 115 (52%) with semi-small (20mm), 69 (32%) small (25mm) and 35 (16%) medium (30mm) ovoids. Mean distance of 100% isodose curve obtained by above ovoids were 3.48 ± 0.53cm, 3.57 ± 0.45cm and 3.80 ± 0.44cm respectively (p = 0.005). Point A doses for respective ovoids were 5.40 ± 0.71 Gy, 5.59 ± 0.75 Gy and 5.79 ± 0.70 Gy (p=0.016) and Total Reference Air Kerma(TRAK) was 4137.35 ± 509.35, 4433.60 ± 554.80 and 4604.72 ± 381.45 mGy m2 h-1 (p < 0.001). No significant impact was observed in the OAR doses.
CONCLUSION: Majority of our patients could accommodate semi-small ovoids. This compromises the distance covered by 100% isodose curve at the level of Point A and the dose to medial parametrial disease (<2cms) as well. Such patients may be receive higher dose within medial parametrium by use of Intracavitary + Interstitial Brachytherapy (IC + ISBT) Keywords: Intra-cavitary Brachytherapy, Size of Ovoids.
METHODS: Cancer cervix Patients treated with concurrent chemoradiotherapy and High Dose Rate(HDR) BT of 6-7 Gy in 3-4 fractions prescribed to point A were identified. Dosimetric details were documented from BT plans.
RESULTS: 219 ICBT applications were performed for 142 patients. 115 (52%) with semi-small (20mm), 69 (32%) small (25mm) and 35 (16%) medium (30mm) ovoids. Mean distance of 100% isodose curve obtained by above ovoids were 3.48 ± 0.53cm, 3.57 ± 0.45cm and 3.80 ± 0.44cm respectively (p = 0.005). Point A doses for respective ovoids were 5.40 ± 0.71 Gy, 5.59 ± 0.75 Gy and 5.79 ± 0.70 Gy (p=0.016) and Total Reference Air Kerma(TRAK) was 4137.35 ± 509.35, 4433.60 ± 554.80 and 4604.72 ± 381.45 mGy m2 h-1 (p < 0.001). No significant impact was observed in the OAR doses.
CONCLUSION: Majority of our patients could accommodate semi-small ovoids. This compromises the distance covered by 100% isodose curve at the level of Point A and the dose to medial parametrial disease (<2cms) as well. Such patients may be receive higher dose within medial parametrium by use of Intracavitary + Interstitial Brachytherapy (IC + ISBT) Keywords: Intra-cavitary Brachytherapy, Size of Ovoids.