Reduced toxicity with equivalent outcomes using three-dimensional volumetric (3DV) image-based versus nonvolumetric point-based (NV) brachytherapy in a cervical cancer population

Kimberly M. Thomas, Genevieve Maquilan, Strahinja Stojadinovic, Paul Medin, Michael R. Folkert, Kevin Albuquerque

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Purpose: Brachytherapy (BT) techniques have historically used a two-dimensional nonvolumetric (NV) system involving dose prescribed to a point fixed in space. We compared dosimetric, toxicity, and oncologic outcomes for volumetric planning (3DV) versus CT point-based planning. Methods and Materials: Patients treated with external beam radiation therapy and high dose rate (HDR) intracavitary BT were included (n = 71). Patients planned with NV BT treated from 2009 to 2011 (n = 37) were compared to patients planned with 3DV BT treated from 2012 to 2014 (n = 34). Investigators delineated volumes for organs at risk clinical target volumes for the 2009-2011 NV cohort. Acute and chronic toxicity data were graded. Results: The mean HDR clinical target volume D90 received in the NV and 3DV cohorts were significantly different (p < 0.001). The mean dose to point A was significantly higher in the NV cohort than in the 3DV cohort (p < 0.001). There were significantly more Grade 3 or higher gastrointestinal toxicities in the NV cohort (p = 0.048). There was a nonsignificant trend toward improved oncologic outcomes for patients undergoing CT-based planning. Conclusions: 3DV BT allows for a significant reduction of dose to critical structures, resulting in decreased gastrointestinal toxicity, while delivering noninferior doses to the high-risk clinical target volume. Outcomes were improved in the 3D cohort trending toward statistical significance.

Original languageEnglish (US)
JournalBrachytherapy
DOIs
StateAccepted/In press - Dec 12 2016

Keywords

  • Brachytherapy
  • Cervical cancer
  • Image-guided
  • Nonvolumetric
  • Point-based
  • STIC
  • Volumetric

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

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