TY - JOUR
T1 - Vaginal dose point reporting in cervical cancer patients treated with combined 2D/3D external beam radiotherapy and 2D/3D brachytherapy
AU - Westerveld, Henrike
AU - Pötter, Richard
AU - Berger, Daniel
AU - Dankulchai, Pittaya
AU - Dörr, Wolfgang
AU - Sora, Mircea-Constantin
AU - Pötter-Lang, Sarah
AU - Kirisits, Christian
PY - 2013
Y1 - 2013
N2 - Traditionally, vaginal dose points have been defined at the vaginal source level, thus not providing dose information for the entire vagina. Since reliable vaginal dose volume/surface histograms are unavailable, a strategy for comprehensive vaginal dose reporting for combined EBRT and BT was established and investigated. An anatomical vaginal reference point was defined at the level of the Posterior-Inferior Border of Symphysis (PIBS), plus two points ±2 cm (mid/introitus vagina). For BT extra points were selected for the upper vagina at 12/3/6/9 o'clock, at the vaginal surface and 5 mm depth. A vaginal reference length (VRL) was defined from ring centre to PIBS. Fifty-nine patients treated for cervical cancer were included in this retrospective feasibility study. The method was applicable to all patients. Total EQD2 doses at PIBS and ±2 cm were 36.7 Gy (3.1-68.2), 49.6 Gy (32.1-89.6) and 4.3 Gy (1.0-46.6). At the vaginal surface at ring level doses were respectively 266.1 Gy (67.6-814.5)/225.9 Gy (61.5-610.5) at 3/9 o'clock, and 85.1 Gy (55.4-140.3)/72.0 Gy (49.1-108.9) at 12/6 o'clock. Mean VRL on MRI was 5.6 cm (2.0-9.4). With this novel system, a comprehensive reporting of vaginal doses is feasible. The present study has demonstrated large dose variations between patients observed in all parts of the vagina, resulting from different contributions from EBRT and BT
AB - Traditionally, vaginal dose points have been defined at the vaginal source level, thus not providing dose information for the entire vagina. Since reliable vaginal dose volume/surface histograms are unavailable, a strategy for comprehensive vaginal dose reporting for combined EBRT and BT was established and investigated. An anatomical vaginal reference point was defined at the level of the Posterior-Inferior Border of Symphysis (PIBS), plus two points ±2 cm (mid/introitus vagina). For BT extra points were selected for the upper vagina at 12/3/6/9 o'clock, at the vaginal surface and 5 mm depth. A vaginal reference length (VRL) was defined from ring centre to PIBS. Fifty-nine patients treated for cervical cancer were included in this retrospective feasibility study. The method was applicable to all patients. Total EQD2 doses at PIBS and ±2 cm were 36.7 Gy (3.1-68.2), 49.6 Gy (32.1-89.6) and 4.3 Gy (1.0-46.6). At the vaginal surface at ring level doses were respectively 266.1 Gy (67.6-814.5)/225.9 Gy (61.5-610.5) at 3/9 o'clock, and 85.1 Gy (55.4-140.3)/72.0 Gy (49.1-108.9) at 12/6 o'clock. Mean VRL on MRI was 5.6 cm (2.0-9.4). With this novel system, a comprehensive reporting of vaginal doses is feasible. The present study has demonstrated large dose variations between patients observed in all parts of the vagina, resulting from different contributions from EBRT and BT
U2 - https://doi.org/10.1016/j.radonc.2013.04.009
DO - https://doi.org/10.1016/j.radonc.2013.04.009
M3 - Article
C2 - 23639578
SN - 0167-8140
VL - 107
SP - 99
EP - 105
JO - Radiotherapy and oncology
JF - Radiotherapy and oncology
IS - 1
ER -