Application of equivalent uniform dose optimization in intracavitary/interstitial brachytherapy for cervical cancer
Zhou Lin1, Jiang Shan1, Yang Zhiyong1, Zhang Daguang2, Zeng Jing3
1School of Mechanical Engineering, Tianjin University, Tianjin 300350, China; 2Department of Radiation Oncology, Cancer Hospital of Tianjin Medical University, Tianjin 300060, China; 3Radiotherapy Room of Department of Gynecological Oncology, Tianjin Central Obstetrics and Gynecology Hospital, Tianjin 300100, China
Abstract：Objective To investigate the application of equivalent uniform dose (EUD) in the combination of intracavitary and interstitial brachytherapy (combined-BT) for cervical cancer. Methods Twenty cervical cancer patients treated with combined-BT in Tianjin Medical University Cancer Institute and Hospital were recruited in this study. For each patient, treatment plans were optimized based on EUD and hybrid EUD (h-EUD). The results were statistically compared with predefined plans generated by Oncentra Brachy v4.3 using hybrid inverse planning optimization (HIPO). Furthermore, virtual uniform interstitial experiments were applied to evaluate the advantage of EUD. Results All three plans showed consistent conformity index. Compared with the HIPO plans, the average D2cm3 of bladder, rectum and intestine in the EUD plans were decreased by 0.22 Gy, 0.23 Gy and 0.28 Gy, and those in the h-EUD plans were declined by 0.16 Gy, 0.22 Gy and 0.24 Gy, respectively. The average EUD of bladder, rectum and intestine in the EUD plans were decreased by 0.14 Gy, 0.20 Gy and 0.15 Gy, and those in the h-EUD plans were declined by 0.20 Gy, 0.13 Gy and 0.16 Gy, respectively (all P<0.05). The virtual interstitialexperiment showed EUD could significantly improve the dose sparing for organs at risk (OARs). Conclusion The application of EUD can significantly improve the dose sparing for normal tissues without compromising dose homogeneity and conformity during combined-BT for cervical cancer.
Zhou Lin,Jiang Shan,Yang Zhiyong et al. Application of equivalent uniform dose optimization in intracavitary/interstitial brachytherapy for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(7): 546-550.
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