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Variation of optimization techniques for high dose rate brachytherapy in cervical cancer treatment
Nuclear Engineering and Technology ( IF 2.7 ) Pub Date : 2021-10-08 , DOI: 10.1016/j.net.2021.10.004
Ahmad Naqiuddin Azahari 1 , Ahmad Tirmizi Ghani 2 , Reduan Abdullah 1, 3 , Jayapramila Jayamani 4 , Gokula Kumar Appalanaido 1 , Jasmin Jalil 1 , Mohd Zahri Abdul Aziz 1
Affiliation  

High dose rate (HDR) brachytherapy treatment planning usually involves optimization methods to deliver uniform dose to the target volume and minimize dose to the healthy tissues. Four optimizations were used to evaluate the high-risk clinical target volume (HRCTV) coverage and organ at risk (OAR). Dose-volume histogram (DVH) and dosimetric parameters were analyzed and evaluated. Better coverage was achieved with PGO (mean CI = 0.95), but there were no significant mean CI differences than GrO (p = 0.03322). Mean EQD2 doses to HRCTV (D90) were also superior for PGO with no significant mean EQD2 doses than GrO (p = 0.9410). The mean EQD2 doses to bladder, rectum, and sigmoid were significantly higher for NO plan than PO, GrO, and PGO. PO significantly reduced the mean EQD2 doses to bladder, rectum, and sigmoid but compromising the conformity index to HRCTV. PGO was superior in conformity index (CI) and mean EQD2 doses to HRCTV compared with the GrO plan but not statistically significant. The mean EQD2 doses to the rectum by PGO plan slightly exceeded the limit from ABS recommendation (mean EQD2 dose = 78.08 Gy EQD2). However, PGO can shorten the treatment planning process without compromising the CI and keeping the OARs dose below the tolerance limit.



中文翻译:

宫颈癌高剂量率近距离放射治疗优化技术的变化

高剂量率 (HDR) 近距离放射治疗计划通常涉及优化方法,以向目标体积提供均匀剂量并最大限度地减少对健康组织的剂量。四个优化用于评估高风险临床靶区 (HRCTV) 覆盖率和风险器官 (OAR)。对剂量体积直方图 (DVH) 和剂量学参数进行了分析和评估。PGO 获得了更好的覆盖率(平均 CI = 0.95),但与 GrO 相比,平均 CI 没有显着差异(p = 0.03322)。PGO 对 HRCTV 的平均 EQD 2剂量 (D 90 ) 也优于 GrO,没有显着的平均 EQD 2剂量 (p = 0.9410)。平均 EQD 2NO 计划对膀胱、直肠和乙状结肠的剂量显着高于 PO、GrO 和 PGO。PO 显着降低了膀胱、直肠和乙状结肠的平均 EQD 2剂量,但损害了对 HRCTV 的整合指数。与 GrO 计划相比,PGO 在一致性指数 (CI) 和平均 EQD 2剂量方面优于 HRCTV,但无统计学意义。PGO 计划对直肠的平均 EQD 2剂量略超过 ABS 建议的限制(平均 EQD 2剂量 = 78.08 Gy EQD 2)。然而,PGO 可以在不影响 CI 并将 OAR 剂量保持在耐受限度以下的情况下缩短治疗计划过程。

更新日期:2021-10-08
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