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Dose accumulation during vaginal cuff brachytherapy based on rigid/deformable registration vs. single plan addition.
Sebastia Sabater1, Ignacio Andres1, Marimar Sevillano1
1Department of Radiation Oncology, Complejo Hospitalario Universitario de Albacete (CHUA), Albacete, Spain.
Brachytherapy
|January 7, 2014
Summary
Single plan (SP) vaginal cuff brachytherapy (VBT) is an effective surrogate for dose summation compared to rigid or deformable registration methods. This approach simplifies treatment planning for early-stage endometrial cancer patients receiving VBT.
Area of Science:
- Radiation Oncology
- Medical Physics
- Gynecologic Oncology
Background:
- Postoperative vaginal cuff brachytherapy (VBT) is a standard treatment for early-stage endometrial cancer.
- Accurate dose summation is crucial for optimizing treatment efficacy and minimizing toxicity in VBT.
Purpose of the Study:
- To compare dose summation using a single plan (SP) approach versus dose summation after rigid or deformable registration for VBT fractions.
- To evaluate the impact of different dose summation methods on organs at risk (rectum and bladder) in patients with early-stage endometrial cancer.
Main Methods:
- Retrospective analysis of 19 patients undergoing VBT.
- Re-segmentation and re-planning of each VBT fraction.
- Comparison of three dose summation scenarios: single plan (SP), rigid dose warping summation (RDWS), and deformable dose warping summation (DDWS).
- Analysis of dose metrics (D0.1cc, D1cc, D2cc, D5cc, D5%, Dmean) for rectum and bladder across 3 and 5 fractions.
Main Results:
- No significant differences in rectal dose parameters were found between SP, RDWS, and DDWS.
- Significant differences in bladder dose metrics (Dmean, D0.1cc, D2cc) were observed in the 5-fraction scenario across all summation methods (p < 0.05).
Conclusions:
- Multi-image planning in VBT results in minimal differences between various dose summation techniques.
- The single plan (SP) approach is a valid and acceptable surrogate for calculating absorbed doses in organs at risk during VBT.
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