Optimizing the planning process in computed tomography-based image-guided adaptive brachytherapy for cervical cancer using a spreadsheet-based daily dose management system

This study developed a system to reduce the treatment planning time for cervical cancer brachytherapy. An in-house Excel spreadsheet was developed to streamline dosimetric evaluation by combining external beam radiotherapy and brachytherapy doses, while also displaying daily dose constraints, a novel feature of the system. This system was validated in 46 consecutive patients who underwent intracavitary and interstitial brachytherapy using several applicators and required more complex dose calculation procedures than intracavitary brachytherapy alone. The proposed system included contouring and catheter reconstruction using multiple treatment planning systems simultaneously and was integrated with Excel spreadsheets for rapid dosimetric evaluation. The median time required for treatment planning was 36 min (range: 12-72 min), which was a much shorter time than those reported previously. This optimized system demonstrated the potential to increase the efficiency of brachytherapy planning to meet prescribed dose constraints without compromising treatment quality.