International journal of medical sciences · 2026
Impact of catheter positioning on planned target volume (PTV) coverage and organs at risk (OARs) in high-dose-rate (HDR) endotracheal brachytherapy: a comparative 2D vs 3D study.
СтатьяСравнительное исследованиеКлинический случайНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Castellón J Navarro, Cacho I Flores, Carrizosa Mc López, Villoslada C Ibáñez, Morcillo M Domínguez, Esteban E Carrasco, Bueno P Sáez, Zarrabeitia Z Zalabarría, Sanz A Pontes, Pérez N Curiel, Avedillo Fj San Miguel, Gallego M Cámara, Ortega M A, García Ma Sáez
Аннотация
BACKGROUND AND PURPOSE: High-dose-rate endobronchial brachytherapy (HDR-BTE) is an effective technique for the treatment of malignant tracheobronchial tumors. Although two-dimensional (2D) planning provides limited dosimetric information and does not accurately assess the relationship between the catheter and the tumor or the dose delivered to organs at risk (OARs), it continues to be used because it ensures adequate PTV coverage, is associated with low toxicity, and minimizes the risk of catheter displacement by avoiding patient transfer to the CT simulation room.
PATIENT AND METHODS: An 83-year-old patient with 2D HDR-BTE for tracheal recurrence of previously resected lung adenocarcinoma was analyzed and compared with four simulated 3D plans based on catheter position relative to the tumor volume, while keeping the active length and prescribed dose constant.
RESULTS: The favorable oblique scenario achieved the best PTV coverage (D90: 9.05 Gy; V100: 100%), although with highest V150 (96.47%) and homogeneity index (IH: 5.14). The unfavorable oblique and posterior positions significantly reduced coverage (V100: 51.4% and 61.29%, respectively). The esophagus was the most sensitive organ, showing the highest doses in the posterior orientation of the catheter. The contralateral lung and heart received low doses; while the aorta showed higher doses in the favorable oblique scenario due to the location of the PTV.
CONCLUSIONS: Catheter orientation in HDR-BTE has a significant impact on PTV coverage and the dose delivered to critical organs. Despite the trend toward 3D planning, there is no direct clinical evidence comparing the two techniques.
PATIENT AND METHODS: An 83-year-old patient with 2D HDR-BTE for tracheal recurrence of previously resected lung adenocarcinoma was analyzed and compared with four simulated 3D plans based on catheter position relative to the tumor volume, while keeping the active length and prescribed dose constant.
RESULTS: The favorable oblique scenario achieved the best PTV coverage (D90: 9.05 Gy; V100: 100%), although with highest V150 (96.47%) and homogeneity index (IH: 5.14). The unfavorable oblique and posterior positions significantly reduced coverage (V100: 51.4% and 61.29%, respectively). The esophagus was the most sensitive organ, showing the highest doses in the posterior orientation of the catheter. The contralateral lung and heart received low doses; while the aorta showed higher doses in the favorable oblique scenario due to the location of the PTV.
CONCLUSIONS: Catheter orientation in HDR-BTE has a significant impact on PTV coverage and the dose delivered to critical organs. Despite the trend toward 3D planning, there is no direct clinical evidence comparing the two techniques.