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Gaceta mexicana de oncología
On-line version ISSN 2565-005XPrint version ISSN 1665-9201
Abstract
CHACON-ANAYA, Silvia C.; DURAN-CRUZ, Mauricio; REDING-BERNAL, Arturo and BARRAGAN-PEREZ, José A.. Dosimetric analysis between Mánchester points A and high-risk clinical target volume in the three-dimensional image-guided branchytherapy for uterine cervical cancer. Gac. mex. oncol. [online]. 2021, vol.20, n.1, pp.4-11. Epub Apr 16, 2021. ISSN 2565-005X. https://doi.org/10.24875/j.gamo.200000311.
Background:
Gynecological brachytherapy has evolved from the concept of punctual prescription (Manchester) to treatment volumes.
Objective:
To analyze the dosimetric result between the prescription at point A and high-risk clinical target volume (HR-CTV).
Methods:
Both plans were performed in 28 patients with stage IB2-IVA cervical cancer (112 applications), the dose used was 4 fractions of 5.62 Gy.
Results:
The mean D90 (dose to 90% volume) and its standard deviation for HR-CTV: 92.1 ± 2.7 Gy, was lower (p < 0.008) than at points A (103.4 ± 21.6 Gy). HR-CTV coverage: 97.8 ± 7.3% was higher (p < 0.000000000043) than with points A (86.6 ± 14.7%). The bladder D2 cc was: 83.8 ± 22.4 Gy vs. ICRU 38 bladder point (66.1 ± 7.6 Gy) (p < 0.0057), demonstrating the underestimation of the dose in the punctual planning. The D2 cc of the rectum was: 73.6 ± 12.7 Gy vs. ICRU 38 straight point (75.1 ± 11.9 Gy) (p < 0.4857), not differing significantly.
Conclusions:
3D brachytherapy provides greater dose coverage for HR-CTV compared to the traditional system, with an underestimation of the dose received in the bladder in the punctual system.
Keywords : Cervical cancer; Brachytherapy; Intracavitary; Manchester; Volumetric.
