Conventional high-dose-rate brachytherapy with concomitant complementary IMRT boost: a novel approach for improving...

Area of Science:

• Radiation Oncology
• Gynecologic Oncology

Background:

• Cervical cancer treatment often involves high-dose-rate (HDR) brachytherapy.
• Achieving optimal target coverage while sparing organs at risk (OARs) remains a challenge.

Purpose of the Study:

• To evaluate the feasibility of combining conventional HDR brachytherapy with an intensity-modulated radiotherapy (IMRT) boost.
• To improve target coverage in cervical cancer patients.

Main Methods:

• Six cervical cancer patients received conventional HDR (C-HDR) treatment.
• Intensity-modulated radiotherapy-HDR (IMRT-HDR) plans were optimized to complement C-HDR, aiming for CTV coverage and OAR sparing.
• Dwell-weight optimized HDR (O-HDR) plans were generated for comparison.

Main Results:

• Conventional HDR (C-HDR) showed poor clinical target volume (CTV) coverage (V(95) <62% in 5 cases).
• Optimized HDR (O-HDR) achieved excellent gross tumor volume coverage (V(95) ≥96.9%) but led to high OAR doses in all patients.
• IMRT-HDR demonstrated significantly improved CTV coverage (average V(95) = 95.3%) with acceptable doses to the bladder and rectum.

Conclusions:

• Concomitant IMRT boost complementary to C-HDR provides superior CTV coverage compared to C-HDR and O-HDR.
• The IMRT-HDR technique effectively balances excellent target coverage with OAR dose constraints in cervical cancer treatment.