A Comparative Analysis of Different Prescription Points in High Dose Rate Brachytherapy of Cervical Cancer.

Document Type : Original Paper

Authors

1 DEPARTMENT OF RADIATION ONCOLOGY,GGS MEDICAL COLLEGE & HOSPITAL

2 Department of Radiation Oncology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Vibhuti Khand Gomti Nagar, Lucknow -226010 India

3 Radiation Oncology Department, Guru Gobind Singh Medical College and Hospital

4 Department of Radiation Oncology, Guru Gobind Singh Medical College and Hospital

5 Advance Cancer Centre

6 Department of Radiotherapy,GMC Patiala, Punjab,India

Abstract

Aim: The dose prescription point in high dose rate (HDR) intracavitary brachytherapy (ICBT) of cervical cancer is Manchester point A but the localization of this point has a wider variations. To minimize these variations, American Brachytherapy Society (ABS) introduced a new definition of point A and termed it as point H. In this study these two points has compared in terms of dosimetric parameters.

Material and Methods: Twenty HDR ICBT of cervical cancer patients were retrospectively evaluated with Manchester point A and ABS point H. Target volume covered by prescribed dose (TV), dose to 2cc (D2cc) of the bladder and rectum were noted for both points. Results: On average, point H was 4.0 mm shifted (superior/inferior) from point A, along the tandem direction. The average TV when prescription done at point H (TVH) was 33.7cc ± 10.1 cc which was higher than the average TV when prescription done at point A (TVA) of 33.3 cc ± 9.4 cc. D2cc increased from 63% to 68% for rectum and 52% to 56% for bladder, when prescription point changed from A to H. Conclusions: As observed, average TV, D2cc of the bladder and rectum were higher in the case of point H prescription plan (PH) as compared with point A prescription plan (PA). The dose difference between PH and PA were found to be statistically significant, so careful consideration is needed to implementation of new point H in clinical practice.

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Articles in Press, Accepted Manuscript
Available Online from 08 January 2022
  • Receive Date: 30 May 2021
  • Revise Date: 02 January 2022
  • Accept Date: 08 January 2022
  • First Publish Date: 08 January 2022