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Statistical Analysis of Interfraction Dose Variations of High-Risk Clinical Target Volume and Organs at Risk for
Brien Washington1, Marcus Randall1, Denise Fabian1
1Department of Radiation Medicine, University of Kentucky, Lexington, Kentucky.
High-dose-rate brachytherapy for cervical cancer shows significant interfraction dosimetric variation (IDV) in the high-risk clinical target volume (HRCTV). This IDV leads to a tendency to underdose the HRCTV, impacting treatment effectiveness.
Area of Science:
- Radiation Oncology
- Medical Physics
- Gynecologic Oncology
Background:
- High-dose-rate (HDR) brachytherapy is a key treatment for cervical cancer.
- Significant uncertainties exist in HDR brachytherapy, particularly regarding dosimetric variations.
- Understanding interfraction dosimetric variation (IDV) is crucial for optimizing treatment outcomes.
Purpose of the Study:
- To quantify the interfraction dosimetric variation (IDV) of the high-risk clinical target volume (HRCTV) in cervical cancer HDR brachytherapy.
- To assess the impact of HRCTV IDV on organ-at-risk (OAR) doses.
- To statistically analyze the correlations between HRCTV and OAR dose variations.
Main Methods:
- Retrospective analysis of 50 cervical cancer patients treated with HDR brachytherapy.
- Evaluation of HRCTV dose (D90) and OAR doses (D0.1cc, D2cc) for rectum, bladder, sigmoid, and bowel.
- Statistical analysis to determine HRCTV IDV and correlations with OAR variations.
Main Results:
- Mean HRCTV variation from prescribed dose was -2.53% ± 8.74%.
- Moderate to weak linear correlations observed between HRCTV and OAR variations, with bladder D2cc showing the strongest correlation.
- A 30.0% probability of underdosing the HRCTV and a 23.3% probability of overdosing were found, linked to non-normal HRCTV IDV distribution.
Conclusions:
- HRCTV IDV in cervical cancer HDR brachytherapy is complexly correlated with OAR doses.
- HRCTV IDV exhibits a left-skewed distribution, indicating a tendency towards underdosing.
- Further investigation is needed to determine the clinical significance of these observed dose variations.
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