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Impact of CT-based planning and bladder volume changes on the dosimetry of vaginal vault brachytherapy

Published online by Cambridge University Press:  09 February 2021

Jeyaanth Venkatasai Open the ORCID record for Jeyaanth Venkatasai [Opens in a new window] ,
Jebakarunya Ramireddy Open the ORCID record for Jebakarunya Ramireddy [Opens in a new window] ,
Arvind Sathyamurthy Open the ORCID record for Arvind Sathyamurthy [Opens in a new window] ,
Henry Finlay Godson ,
Reka Karuppusami Open the ORCID record for Reka Karuppusami [Opens in a new window] ,
Saikat Das  and
Thomas Samuel Ram Open the ORCID record for Thomas Samuel Ram [Opens in a new window]
Jeyaanth Venkatasai*
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Jebakarunya Ramireddy
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Arvind Sathyamurthy
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Henry Finlay Godson
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
Reka Karuppusami
Affiliation:
Department of Biostatistics, Christian Medical College, Vellore, India
Saikat Das
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India Department of Radiation Oncology, AIIMS, Bhopal, India
Thomas Samuel Ram
Affiliation:
Department of Radiation Oncology, Dr Ida B Scudder Cancer Centre, Christian Medical College, Vellore, India
*
Author for correspondence: Dr Jeyaanth Venkatasai, Department of Radiation Oncology, Dr Ida B Scudder Cancer Center, Christian Medical College, Vellore, Tamil Nadu632004, India. Tel: +91-9444275245/0416-228-3145. E-mail: jeyaanth@gmail.com
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Abstract

Aim:

To compare dose to target and organs at risk (OARs) in conventional plan (2D) versus computed tomography (CT)-based three-dimensional (3D) plan in vaginal cuff brachytherapy (VBT) and to compare the effect of bladder distension on target and OARs dosimetry.

Materials and methods:

Post-hysterectomy patients with an indication for VBT were included in the study. All patients underwent planning CT scans with a full bladder and an empty bladder protocol. For each CT, two plans were generated—one library-based 2D plan and another CT-based 3D plan. Dosimetric parameters were recorded for clinical target volume (CTV) and OARs.

Results:

A total of 92 observations were made from data collected from 46 patients. Difference between CTV dose in terms of 2D and 3D plans were not statistically significant for CTV (p = 0·11). Significant reduction in D0·1cc, D1cc and D2cc dose parameters were observed in bladder, rectum, sigmoid and bowel doses with the 3D plan (p < 0·001). Bladder distension showed a 20% reduction in dose for bowel (p < 0·001). Bladder distension also showed a 6·12% (p = 0·047) increase in D2cc, but there was a significant reduction in the mean dose to the bladder.

Conclusion:

Our study demonstrates the dosimetric benefits with 3D CT-based planning for VBT over 2D-based conventional planning and benefit of bladder distension in the reduction of bowel dose without compromising dose to the target volume.

Keywords

bladderCT-based planninggynaecological cancerVaginal brachytherapy
Type
Original Article
Information
Journal of Radiotherapy in Practice , Volume 21 , Issue 3 , September 2022 , pp. 321 - 327
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

*

This article was originally published without naming one of the authors, Saikat Das. This error has now been corrected and a corrigendum can be found at https://doi.org/10.1017/S1460396921000534.

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