Abstract
Purpose
The study is an audit of reporting dose and volume specifications as per the ICRU
58 for MUPIT-based interstitial brachytherapy in gynecological cancers. Correlation
between total reference air kerma (TRAK) and isodose surface was also evaluated to
understand the intensity of treatment in interstitial brachytherapy.
Methods and Materials
Forty-two patients underwent HDR MUPIT-based interstitial brachytherapy 20 Gy in five
fractions after EBRT during 2017–2019. Treated volume, high and low-dose regions,
mean central dose, Dose Homogeneity Index (DHI), organ at risk doses, and TRAK values
were computed.
Results
High-dose regions V150 mean was 12.4 cc and V200 was 4.58 cc; and low-dose region
was 75.92 cc. The mean treated volume was 59.8 cc. The mean central dose was 3.7 Gy.
DHI was 79%. The mean D2cm3 bladder and rectum were 2.9 Gy and 2.8 Gy. The mean TRAK was 0.16 cGy per fraction
per hour at 1 m. TRAK values showed significant correlation with various isodose volumes
(TRAK and V100: r = 0.943 p < 0.0005; and TRAK and V50: r = 0.953; p < 0.0005). A positive correlation was observed between TRAK and the number of needles
(r = 0.746; p < 0.0005). At a median followup of 16 months, 4 of 42 patients (9.5%) had local recurrences.
Conclusions
Our study shows compliance with ICRU 58 recommendations along with certain deviations.
Local recurrence rate is acceptable. TRAK shows correlation with surface isodose in
MUPIT-based brachytherapy and should to be evaluated in future studies.
Keywords
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References
- The role of interstitial brachytherapy using template in locally advanced gynecological malignancies.Gynecol Oncol. 2005; 99: 169-175
Dose and Volume Specification for Reporting Interstitial Therapy - ICRU Report 58, 1997.
- Isodose surface volumes in cervix cancer brachytherapy: Change of practice from standard (point A) to individualized image guided adaptive (EMBRACE I) brachytherapy.Radiother Oncol. 2018; 129: 567-574
- Total reference air kerma: To what extent can it predict intracavitary volume enclosed by isodose surfaces during multiple high-dose rate brachytherapy?.Brachytherapy. 2003; 2: 91-97
- Total reference air kerma can accurately predict isodose surface volumes in cervix cancer brachytherapy. A multicenter study.Brachytherapy. 2017; 16: 1184-1191
- Analysis of fat necrosis after adjuvant high-dose-rate interstitial brachytherapy for early stage breast cancer.Brachytherapy. 2013; 12: 99-106
- Clinically evident fat necrosis in women treated with high-dose-rate brachytherapy alone for early-stage breast cancer.Int J Radiat Oncol. 2001; 50: 107-111
- Evaluation of quality indices during multifractionated pelvic interstitial brachytherapy for cervical cancer.Brachytherapy. 2013; 12: 156-161
- TRAK relates to prescription isodose surface volume and treatment time in vaginal cylinder HDR brachytherapy.Brachytherapy. 2019; 18: S113
- Treatment volume from Total Reference Air Kerma (TRAK) in intracavitory applications and its comparison with ICRU reference volume.Int J Radiat Oncol. 1994; 28: 499-504
- Estimation of tissue volume irradiated by intracavitary implants.Int J Radiat Oncol. 1993; 25: 733-744
- TRAK as a patient-specific QA tool in gynaecological cancer brachytherapy.(Available at:)
- 142 Oral Volume in intracavitary therapy; the first proof that it is clinically significant.Radiother Oncol. 2002; 64: S47-S48
- Total reference air kerma is associated with late bowel morbidity in locally advanced cervical cancer patients treated with image-guided adaptive brachytherapy.J Clin Med. 2019; 8: 125
- MRI- and PET-guided interstitial brachytherapy for postsurgical vaginal recurrences of cervical cancer: Results of phase II study.Int J Radiat Oncol. 2020; 106: 310-319
Article Info
Publication History
Published online: February 26, 2021
Accepted:
January 17,
2021
Received in revised form:
January 8,
2021
Received:
June 22,
2020
Footnotes
Disclosures: None of the authors have any conflict of interest to declare or any financial disclosure.
Identification
Copyright
© 2021 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.