Sophia Scharl1,2, Christine Hugo1, Clara-Bianca Weidenbächer1, Holger Bronger3, Christine Brambs3, Marion Kiechle3, Marcus R Makowski4, Stephanie E Combs1,5,6, Lars Schüttrumpf7. 1. Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany. 2. Department of Radiation Oncology, University Hospital Ulm, Albert-Einstein-Allee 23, Ulm, Germany. 3. Department of Obstetrics and Gynecology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany. 4. Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 5. Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partner Site Munich, Munich, Germany. 6. Institute of Radiation Medicine (IRM), Helmholtz Zentrum München, Ingolstädter Landstraße 1, Neuherberg, Germany. 7. Department of Radiation Oncology, Technische Universität München (TUM), Ismaninger Straße 22, Munich, Germany. lars.schuettrumpf@mri.tum.de.
Abstract
PURPOSE: Brachytherapy is a mandatory component of primary radiochemotherapy in cervical cancer. The dose can be applied with a traditional intracavitary approach (IC alone) or with multiple catheter brachytherapy to optimize dose distribution in an individual concept. We therefore evaluated whether the utilization of a tandem-ring applicator plus additional intracavitary applicators (add IC) provides an advantage over the traditional IC alone approach, as this method is less time consuming and less invasive compared to a combined intracavitary/interstitial brachytherapy. METHODS: Twenty three procedures of intracavitary brachytherapy for cervical cancer with additional intracavitary applicators performed in seven patients treated between 2016 and 2018 in our institution were included in this study. Plans were optimized for D90 HR-CTV with and without the utilization of the additional applicators and compared by statistical analysis. RESULTS: D90 for HR-CTV was 5.71 Gy (±1.17 Gy) for fractions optimized with add IC approach and 5.29 Gy (±1.24 Gy) for fractions without additional applicators (p < 0.01). This translates to a calculated mean EQD2 HR-CTV D90 of 80.72 Gy (±8.34 Gy) compared to 77.84 Gy (±8.49 Gy) after external beam therapy and four fractions of brachytherapy for add IC and IC alone, respectively (p < 0.01). The predictive value of improved coverage of HR-CTV in the first fraction was high. CONCLUSION: In a subgroup of cases, the addition of intracavitary Heyman capsules can be an alternative to interstitial brachytherapy to improve the plan quality compared to standard IC alone brachytherapy. The benefit from the addition of applicators in the first fraction is predictive for the following fractions.
PURPOSE: Brachytherapy is a mandatory component of primary radiochemotherapy in cervical cancer. The dose can be applied with a traditional intracavitary approach (IC alone) or with multiple catheter brachytherapy to optimize dose distribution in an individual concept. We therefore evaluated whether the utilization of a tandem-ring applicator plus additional intracavitary applicators (add IC) provides an advantage over the traditional IC alone approach, as this method is less time consuming and less invasive compared to a combined intracavitary/interstitial brachytherapy. METHODS: Twenty three procedures of intracavitary brachytherapy for cervical cancer with additional intracavitary applicators performed in seven patients treated between 2016 and 2018 in our institution were included in this study. Plans were optimized for D90 HR-CTV with and without the utilization of the additional applicators and compared by statistical analysis. RESULTS: D90 for HR-CTV was 5.71 Gy (±1.17 Gy) for fractions optimized with add IC approach and 5.29 Gy (±1.24 Gy) for fractions without additional applicators (p < 0.01). This translates to a calculated mean EQD2 HR-CTV D90 of 80.72 Gy (±8.34 Gy) compared to 77.84 Gy (±8.49 Gy) after external beam therapy and four fractions of brachytherapy for add IC and IC alone, respectively (p < 0.01). The predictive value of improved coverage of HR-CTV in the first fraction was high. CONCLUSION: In a subgroup of cases, the addition of intracavitary Heyman capsules can be an alternative to interstitial brachytherapy to improve the plan quality compared to standard IC alone brachytherapy. The benefit from the addition of applicators in the first fraction is predictive for the following fractions.
Authors: Richard Pötter; Christine Haie-Meder; Erik Van Limbergen; Isabelle Barillot; Marisol De Brabandere; Johannes Dimopoulos; Isabelle Dumas; Beth Erickson; Stefan Lang; An Nulens; Peter Petrow; Jason Rownd; Christian Kirisits Journal: Radiother Oncol Date: 2006-01-05 Impact factor: 6.280
Authors: Christian Kirisits; Stefan Lang; Johannes Dimopoulos; Daniel Berger; Dietmar Georg; Richard Pötter Journal: Int J Radiat Oncol Biol Phys Date: 2006-06-01 Impact factor: 7.038
Authors: Christel N Nomden; Astrid A C de Leeuw; Marinus A Moerland; Judith M Roesink; Robbert J H A Tersteeg; Ina Maria Jürgenliemk-Schulz Journal: Int J Radiat Oncol Biol Phys Date: 2011-06-12 Impact factor: 7.038
Authors: Christine H Holschneider; Daniel G Petereit; Christina Chu; I-Chow Hsu; Yevgeniya J Ioffe; Ann H Klopp; Bhavana Pothuri; Lee-May Chen; Catheryn Yashar Journal: Brachytherapy Date: 2019-01-18 Impact factor: 2.362
Authors: Christine Haie-Meder; Richard Pötter; Erik Van Limbergen; Edith Briot; Marisol De Brabandere; Johannes Dimopoulos; Isabelle Dumas; Taran Paulsen Hellebust; Christian Kirisits; Stefan Lang; Sabine Muschitz; Juliana Nevinson; An Nulens; Peter Petrow; Natascha Wachter-Gerstner Journal: Radiother Oncol Date: 2005-03 Impact factor: 6.280
Authors: Barrett OʼDonnell; Jay C Shiao; Todd A Pezzi; Nabila Waheed; Shelly Sharma; Mark D Bonnen; Michelle S Ludwig Journal: Int J Gynecol Cancer Date: 2018-03 Impact factor: 3.437