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Selection criteria for high-dose-rate surface brachytherapy and electron beam therapy in cutaneous oncology
Journal of Contemporary Brachytherapy ( IF 1.1 ) Pub Date : 2021-04-14 , DOI: 10.5114/jcb.2021.105288
Ivan M Buzurovic 1 , Desmond A O'Farrell 1 , Thomas C Harris 1 , Scott Friesen 1 , Martin T King 1 , Robert A Cormack 1 , Phillip M Devlin 1
Affiliation  

Introduction
High-dose-rate (HDR) brachytherapy is an alternative treatment to electron external beam radiation therapy (EBRT) of superficial skin lesions. The purpose of this study was to establish the selection criteria for HDR brachytherapy technique (HDR-BT) and EBRT in cutaneous oncology for various clinical scenarios.

Material and methods
The study consists of two parts: a) EBRT and HDR-BT treatment plans comparison analyzing clinical target volumes (CTVs) with different geometries, field sizes, and topologies, and b) development of a prediction model capable of characterization of dose distributions in HDR surface brachytherapy for various geometries of treatment sites.

Results
A loss of CTV coverage for the electron plans (D90, D95) was recorded up to 45%, when curvature of the applicator increased over 30. Values for D2 cm3 for both plans were comparable, and they were in range of ±8% of prescription dose. An increase in higher doses (D0.5 cm3 and D0.1 cm3) was observed in HDR-BT plans, and it was greater for larger lesions. The average increase was 3.8% for D0.5 cm3 and 12.3% for D0.1 cm3. When CTV was approximately flat, electron plans were comparable with HDR-BT plans, having lower average D2 cm3, D0.5 cm3, and D0.1 cm3 of 7.7%. Degradation of quality of electron plans was found to be more dependent on target curvature than on CTV size.

Conclusions
Both EBRT and HDR-BT could be used in treatments of superficial lesions. HDR-BT revealed superior CTV coverage when the surface was very large, complex, curvy, or rounded, and when the topology was complicated. The prediction model can be used for an approximate calculation and quick assessment of radiation dose to organs-at-risk (OARs), at a depth or at a lateral distance from CTV.



中文翻译:

皮肤肿瘤学中高剂量率表面近距离放射治疗和电子束治疗的选择标准

简介
高剂量率 (HDR) 近距离放射治疗是对浅表皮损的电子外束放射治疗 (EBRT) 的替代治疗。本研究的目的是为各种临床情况建立皮肤肿瘤学中 HDR 近距离放射治疗技术 (HDR-BT) 和 EBRT 的选择标准。

材料和方法
该研究由两部分组成:a) EBRT 和 HDR-BT 治疗计划比较分析具有不同几何形状、射野大小和拓扑的临床靶区 (CTV),以及 b) 开发能够表征剂量的预测模型HDR 表面近距离放射治疗中各种几何形状治疗部位的分布。

结果
当涂药器的曲率增加超过 30 时,记录到电子计划(D90、D95)的 CTV 覆盖率损失高达 45%。两个计划的 D2 cm3 值具有可比性,它们在处方剂量的 ±8% 范围内。在 HDR-BT 计划中观察到较高剂量(D0.5 cm3 和 D0.1 cm3)的增加,并且对于较大的病变更大。D0.5 cm3 的平均增幅为 3.8%,D0.1 cm3 的平均增幅为 12.3%。当 CTV 大致持平时,电子计划与 HDR-BT 计划相当,平均 D2 cm3、D0.5 cm3 和 D0.1 cm3 较低,为 7.7%。发现电子计划质量的下降更多地取决于目标曲率而不是 CTV 尺寸。

结论
EBRT 和 HDR-BT 均可用于浅表病变的治疗。当表面非常大、复杂、弯曲或圆形以及拓扑结构复杂时,HDR-BT 显示出卓越的 CTV 覆盖率。该预测模型可用于近似计算和快速评估危险器官 (OAR)、深度或横向距离 CTV 的辐射剂量。

更新日期:2021-04-15
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