Journal article
The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer
Journal of contemporary brachytherapy, Vol.5(1), pp.17-22
03/2013
DOI: 10.5114/jcb.2013.34449
PMCID: PMC3635049
PMID: 23634151
Abstract
Purpose: We perform a clinical retrospective study to determine whether a vaginal balloon-packing system provides a dosimetric reduction to organs at risk (OARs) versus traditional gauze packing for gynecological high-dose-rate brachytherapy (HDR-BT). We also test various balloon filling materials for optimizing imaging quality.
Material and methods: Filling materials for balloon-packing were evaluated based on imaging quality with X-ray, computerized tomography, and magnetic resonance imaging modalities. We then retrospectively reviewed 45 HDR-BT plans of 18 patients performed with gauze packing and 39 plans of 16 patients performed with balloon-packing. Twelve patients received both gauze and balloon-packing. HDR-BT was delivered with an iridium-192 afterloader and a Fletcher-Suit-Declos-style T&O applicator. At each fraction, 3D imaging was obtained. The D2cc values of OARs were calculated, as well as ICRU-defined point doses.
Results: In the 84 HDR fractions reviewed, vaginal balloon-packing provides statistically equivalent doses to rectum, bladder, and sigmoid compared to gauze packing. On average balloon-packing produced average reductions of 3.3% and 6.9% in the rectal and sigmoid D2cc doses and an increase of 3.2% to the bladder D2cc dose (normalized to prescription dose), although none of these values were statistically significant for the twelve patients who received both gauze and balloon-packing (32 and 40 total fractions, respectively).
Conclusions: In the 84 HDR fractions analyzed, vaginal balloon-packing is as effective as gauze packing for dose sparing to the rectum, bladder, and sigmoid. A 1: 1 solution of saline and contrast for filling material enables easy contouring for image-guided HDR with minimal artefacts.
Details
- Title: Subtitle
- The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer
- Creators
- William M Rockey - Radiation Oncology Department, The University of IowaSudershan K Bhatia - Radiation Oncology Department, The University of IowaGeraldine M Jacobson - Radiation Oncology Department, West Virginia University, USAYusung Kim - Radiation Oncology Department, The University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of contemporary brachytherapy, Vol.5(1), pp.17-22
- DOI
- 10.5114/jcb.2013.34449
- PMID
- 23634151
- PMCID
- PMC3635049
- NLM abbreviation
- J Contemp Brachytherapy
- ISSN
- 1689-832X
- eISSN
- 2081-2841
- Publisher
- Termedia Publishing House
- Language
- English
- Date published
- 03/2013
- Academic Unit
- Radiation Oncology
- Record Identifier
- 9984047896502771
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