A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy
Abstract Background and purpose To compare the dosimetric impact of organ and target variations relative to the applicator for intracavitary brachytherapy by a multicentre analysis with different application techniques and fractionation schemes. Material and methods DVH data from 363 image/contour s...
Gespeichert in:
| Veröffentlicht in: | Radiotherapy and oncology 2013-04, Vol.107 (1), p.20-25 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 25 |
|---|---|
| container_issue | 1 |
| container_start_page | 20 |
| container_title | Radiotherapy and oncology |
| container_volume | 107 |
| creator | Nesvacil, Nicole Tanderup, Kari Hellebust, Taran P De Leeuw, Astrid Lang, Stefan Mohamed, Sandy Jamema, Swamidas V Anderson, Clare Pötter, Richard Kirisits, Christian |
| description | Abstract Background and purpose To compare the dosimetric impact of organ and target variations relative to the applicator for intracavitary brachytherapy by a multicentre analysis with different application techniques and fractionation schemes. Material and methods DVH data from 363 image/contour sets (120 patients, 6 institutions) were included for 1–6 fractions per patient, with imaging intervals ranging from several hours to ∼20 days. Variations between images acquired within one (intra-application) or between consecutive applicator insertions (inter-application) were evaluated. Dose plans based on a reference MR or CT image series were superimposed onto subsequent image sets and D 2 cm 3 for the bladder, rectum and sigmoid and D90 for HR CTV were recorded. Results For the whole sample, the systematic dosimetric variations for all organs at risk, i.e. mean variations of D 2 cm 3 , were found to be minor ( |
| doi_str_mv | 10.1016/j.radonc.2013.01.012 |
| format | Article |
| fullrecord | <record><control><sourceid>elsevier_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3675683</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0167814013000285</els_id><sourcerecordid>1_s2_0_S0167814013000285</sourcerecordid><originalsourceid>FETCH-LOGICAL-c584t-8adfaeca35d8688c63e62940accb4324fb66416f79a63d59fe39c12a86de46493</originalsourceid><addsrcrecordid>eNqFUtuOEzEMjRCILQt_gFB-YEouM5nMC9JqxQLSSjwAz5GbeGjKzKRK0or-Bl9MQqFcXpAsxfKxjx0fE_KcszVnXL3crSO4sNi1YFyuGS8mHpAV1_3QMK37h2RV0vpG85ZdkScp7Rhjgsn-MbkSUjEhe7Ei327ofJiyt7jkiNSGeQ_Rp7DQMNK8RepC8jPm6C31BbO5An7JGBsKi6tuhGaMBfFhgakEIYfZ2-IeCxXUcCpp9JKT0VGL8ei_UgtL8eimQNtTaRdhf3pKHo0wJXz2870mn-5ef7x929y_f_Pu9ua-sZ1uc6PBjYAWZOe00toqiUoMLQNrN60U7bhRquVq7AdQ0nXDiHKwXIBWDlvVDvKavDrz7g-bGd2PDcBk9tHPEE8mgDd_I4vfms_haKTqO6VlIWjPBDaGlCKOl1rOTNXI7MxZI1M1MowXE6XsxZ99L0W_RPk9GJbfHz1Gk6zHsijnI9psXPD_6_AvgZ38UiX5gidMu3CIRalkuEnCMPOh3kk9Ey7riehOfgfgYr8x</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Nesvacil, Nicole ; Tanderup, Kari ; Hellebust, Taran P ; De Leeuw, Astrid ; Lang, Stefan ; Mohamed, Sandy ; Jamema, Swamidas V ; Anderson, Clare ; Pötter, Richard ; Kirisits, Christian</creator><creatorcontrib>Nesvacil, Nicole ; Tanderup, Kari ; Hellebust, Taran P ; De Leeuw, Astrid ; Lang, Stefan ; Mohamed, Sandy ; Jamema, Swamidas V ; Anderson, Clare ; Pötter, Richard ; Kirisits, Christian</creatorcontrib><description>Abstract Background and purpose To compare the dosimetric impact of organ and target variations relative to the applicator for intracavitary brachytherapy by a multicentre analysis with different application techniques and fractionation schemes. Material and methods DVH data from 363 image/contour sets (120 patients, 6 institutions) were included for 1–6 fractions per patient, with imaging intervals ranging from several hours to ∼20 days. Variations between images acquired within one (intra-application) or between consecutive applicator insertions (inter-application) were evaluated. Dose plans based on a reference MR or CT image series were superimposed onto subsequent image sets and D 2 cm 3 for the bladder, rectum and sigmoid and D90 for HR CTV were recorded. Results For the whole sample, the systematic dosimetric variations for all organs at risk, i.e. mean variations of D 2 cm 3 , were found to be minor (<5%), while random variations, i.e. standard deviations were found to be high due to large variations in individual cases. The D 2 cm 3 variations (mean ± 1SD) were 0.6 ± 19.5%, 4.1 ± 21.7% and 1.6 ± 26.8%, for the bladder, rectum and sigmoid. For HR CTV, the variations of D 90 were found to be −1.1 ± 13.1% for the whole sample. Grouping of the results by intra- and inter-application variations showed that random uncertainties for bladder and sigmoid were 3–7% larger when re-implanting the applicator for individual fractions. No statistically significant differences between the two groups were detected in dosimetric variations for the HR CTV. Using 20% uncertainty of physical dose for OAR and 10% for HR CTV, the effects on total treatment dose for a 4 fraction HDR schedule at clinically relevant dose levels were found to be 4–8 Gy EQD2 for OAR and 3 Gy EQD2 for HR CTV. Conclusions Substantial variations occur in fractionated cervix cancer BT with higher impact close to clinical threshold levels. The treatment approach has to balance uncertainties for individual cases against the use of repetitive imaging, adaptive planning and dose delivery.</description><identifier>ISSN: 0167-8140</identifier><identifier>EISSN: 1879-0887</identifier><identifier>DOI: 10.1016/j.radonc.2013.01.012</identifier><identifier>PMID: 23602372</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Adaptive brachytherapy ; Brachytherapy - methods ; Cervix cancer brachytherapy ; Dose Fractionation, Radiation ; Female ; Hematology, Oncology and Palliative Medicine ; Humans ; Image Guided Brachytherapy ; Interfraction variations ; Radiotherapy Dosage ; Radiotherapy, Image-Guided - methods ; Tumor Burden ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - radiotherapy</subject><ispartof>Radiotherapy and oncology, 2013-04, Vol.107 (1), p.20-25</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2013 Elsevier Ireland Ltd</rights><rights>Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.</rights><rights>2013 Elsevier Ireland Ltd. 2013 Elsevier Ireland Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-8adfaeca35d8688c63e62940accb4324fb66416f79a63d59fe39c12a86de46493</citedby><cites>FETCH-LOGICAL-c584t-8adfaeca35d8688c63e62940accb4324fb66416f79a63d59fe39c12a86de46493</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0167814013000285$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23602372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nesvacil, Nicole</creatorcontrib><creatorcontrib>Tanderup, Kari</creatorcontrib><creatorcontrib>Hellebust, Taran P</creatorcontrib><creatorcontrib>De Leeuw, Astrid</creatorcontrib><creatorcontrib>Lang, Stefan</creatorcontrib><creatorcontrib>Mohamed, Sandy</creatorcontrib><creatorcontrib>Jamema, Swamidas V</creatorcontrib><creatorcontrib>Anderson, Clare</creatorcontrib><creatorcontrib>Pötter, Richard</creatorcontrib><creatorcontrib>Kirisits, Christian</creatorcontrib><title>A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy</title><title>Radiotherapy and oncology</title><addtitle>Radiother Oncol</addtitle><description>Abstract Background and purpose To compare the dosimetric impact of organ and target variations relative to the applicator for intracavitary brachytherapy by a multicentre analysis with different application techniques and fractionation schemes. Material and methods DVH data from 363 image/contour sets (120 patients, 6 institutions) were included for 1–6 fractions per patient, with imaging intervals ranging from several hours to ∼20 days. Variations between images acquired within one (intra-application) or between consecutive applicator insertions (inter-application) were evaluated. Dose plans based on a reference MR or CT image series were superimposed onto subsequent image sets and D 2 cm 3 for the bladder, rectum and sigmoid and D90 for HR CTV were recorded. Results For the whole sample, the systematic dosimetric variations for all organs at risk, i.e. mean variations of D 2 cm 3 , were found to be minor (<5%), while random variations, i.e. standard deviations were found to be high due to large variations in individual cases. The D 2 cm 3 variations (mean ± 1SD) were 0.6 ± 19.5%, 4.1 ± 21.7% and 1.6 ± 26.8%, for the bladder, rectum and sigmoid. For HR CTV, the variations of D 90 were found to be −1.1 ± 13.1% for the whole sample. Grouping of the results by intra- and inter-application variations showed that random uncertainties for bladder and sigmoid were 3–7% larger when re-implanting the applicator for individual fractions. No statistically significant differences between the two groups were detected in dosimetric variations for the HR CTV. Using 20% uncertainty of physical dose for OAR and 10% for HR CTV, the effects on total treatment dose for a 4 fraction HDR schedule at clinically relevant dose levels were found to be 4–8 Gy EQD2 for OAR and 3 Gy EQD2 for HR CTV. Conclusions Substantial variations occur in fractionated cervix cancer BT with higher impact close to clinical threshold levels. The treatment approach has to balance uncertainties for individual cases against the use of repetitive imaging, adaptive planning and dose delivery.</description><subject>Adaptive brachytherapy</subject><subject>Brachytherapy - methods</subject><subject>Cervix cancer brachytherapy</subject><subject>Dose Fractionation, Radiation</subject><subject>Female</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Image Guided Brachytherapy</subject><subject>Interfraction variations</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Image-Guided - methods</subject><subject>Tumor Burden</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - radiotherapy</subject><issn>0167-8140</issn><issn>1879-0887</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUtuOEzEMjRCILQt_gFB-YEouM5nMC9JqxQLSSjwAz5GbeGjKzKRK0or-Bl9MQqFcXpAsxfKxjx0fE_KcszVnXL3crSO4sNi1YFyuGS8mHpAV1_3QMK37h2RV0vpG85ZdkScp7Rhjgsn-MbkSUjEhe7Ei327ofJiyt7jkiNSGeQ_Rp7DQMNK8RepC8jPm6C31BbO5An7JGBsKi6tuhGaMBfFhgakEIYfZ2-IeCxXUcCpp9JKT0VGL8ei_UgtL8eimQNtTaRdhf3pKHo0wJXz2870mn-5ef7x929y_f_Pu9ua-sZ1uc6PBjYAWZOe00toqiUoMLQNrN60U7bhRquVq7AdQ0nXDiHKwXIBWDlvVDvKavDrz7g-bGd2PDcBk9tHPEE8mgDd_I4vfms_haKTqO6VlIWjPBDaGlCKOl1rOTNXI7MxZI1M1MowXE6XsxZ99L0W_RPk9GJbfHz1Gk6zHsijnI9psXPD_6_AvgZ38UiX5gidMu3CIRalkuEnCMPOh3kk9Ey7riehOfgfgYr8x</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Nesvacil, Nicole</creator><creator>Tanderup, Kari</creator><creator>Hellebust, Taran P</creator><creator>De Leeuw, Astrid</creator><creator>Lang, Stefan</creator><creator>Mohamed, Sandy</creator><creator>Jamema, Swamidas V</creator><creator>Anderson, Clare</creator><creator>Pötter, Richard</creator><creator>Kirisits, Christian</creator><general>Elsevier Ireland Ltd</general><general>Elsevier Scientific Publishers</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20130401</creationdate><title>A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy</title><author>Nesvacil, Nicole ; Tanderup, Kari ; Hellebust, Taran P ; De Leeuw, Astrid ; Lang, Stefan ; Mohamed, Sandy ; Jamema, Swamidas V ; Anderson, Clare ; Pötter, Richard ; Kirisits, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c584t-8adfaeca35d8688c63e62940accb4324fb66416f79a63d59fe39c12a86de46493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adaptive brachytherapy</topic><topic>Brachytherapy - methods</topic><topic>Cervix cancer brachytherapy</topic><topic>Dose Fractionation, Radiation</topic><topic>Female</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Image Guided Brachytherapy</topic><topic>Interfraction variations</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Image-Guided - methods</topic><topic>Tumor Burden</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - radiotherapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nesvacil, Nicole</creatorcontrib><creatorcontrib>Tanderup, Kari</creatorcontrib><creatorcontrib>Hellebust, Taran P</creatorcontrib><creatorcontrib>De Leeuw, Astrid</creatorcontrib><creatorcontrib>Lang, Stefan</creatorcontrib><creatorcontrib>Mohamed, Sandy</creatorcontrib><creatorcontrib>Jamema, Swamidas V</creatorcontrib><creatorcontrib>Anderson, Clare</creatorcontrib><creatorcontrib>Pötter, Richard</creatorcontrib><creatorcontrib>Kirisits, Christian</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiotherapy and oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nesvacil, Nicole</au><au>Tanderup, Kari</au><au>Hellebust, Taran P</au><au>De Leeuw, Astrid</au><au>Lang, Stefan</au><au>Mohamed, Sandy</au><au>Jamema, Swamidas V</au><au>Anderson, Clare</au><au>Pötter, Richard</au><au>Kirisits, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy</atitle><jtitle>Radiotherapy and oncology</jtitle><addtitle>Radiother Oncol</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>107</volume><issue>1</issue><spage>20</spage><epage>25</epage><pages>20-25</pages><issn>0167-8140</issn><eissn>1879-0887</eissn><abstract>Abstract Background and purpose To compare the dosimetric impact of organ and target variations relative to the applicator for intracavitary brachytherapy by a multicentre analysis with different application techniques and fractionation schemes. Material and methods DVH data from 363 image/contour sets (120 patients, 6 institutions) were included for 1–6 fractions per patient, with imaging intervals ranging from several hours to ∼20 days. Variations between images acquired within one (intra-application) or between consecutive applicator insertions (inter-application) were evaluated. Dose plans based on a reference MR or CT image series were superimposed onto subsequent image sets and D 2 cm 3 for the bladder, rectum and sigmoid and D90 for HR CTV were recorded. Results For the whole sample, the systematic dosimetric variations for all organs at risk, i.e. mean variations of D 2 cm 3 , were found to be minor (<5%), while random variations, i.e. standard deviations were found to be high due to large variations in individual cases. The D 2 cm 3 variations (mean ± 1SD) were 0.6 ± 19.5%, 4.1 ± 21.7% and 1.6 ± 26.8%, for the bladder, rectum and sigmoid. For HR CTV, the variations of D 90 were found to be −1.1 ± 13.1% for the whole sample. Grouping of the results by intra- and inter-application variations showed that random uncertainties for bladder and sigmoid were 3–7% larger when re-implanting the applicator for individual fractions. No statistically significant differences between the two groups were detected in dosimetric variations for the HR CTV. Using 20% uncertainty of physical dose for OAR and 10% for HR CTV, the effects on total treatment dose for a 4 fraction HDR schedule at clinically relevant dose levels were found to be 4–8 Gy EQD2 for OAR and 3 Gy EQD2 for HR CTV. Conclusions Substantial variations occur in fractionated cervix cancer BT with higher impact close to clinical threshold levels. The treatment approach has to balance uncertainties for individual cases against the use of repetitive imaging, adaptive planning and dose delivery.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>23602372</pmid><doi>10.1016/j.radonc.2013.01.012</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0167-8140 |
| ispartof | Radiotherapy and oncology, 2013-04, Vol.107 (1), p.20-25 |
| issn | 0167-8140 1879-0887 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3675683 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adaptive brachytherapy Brachytherapy - methods Cervix cancer brachytherapy Dose Fractionation, Radiation Female Hematology, Oncology and Palliative Medicine Humans Image Guided Brachytherapy Interfraction variations Radiotherapy Dosage Radiotherapy, Image-Guided - methods Tumor Burden Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - radiotherapy |
| title | A multicentre comparison of the dosimetric impact of inter- and intra-fractional anatomical variations in fractionated cervix cancer brachytherapy |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-06T20%3A20%3A26IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-elsevier_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20multicentre%20comparison%20of%20the%20dosimetric%20impact%20of%20inter-%20and%20intra-fractional%20anatomical%20variations%20in%20fractionated%20cervix%20cancer%20brachytherapy&rft.jtitle=Radiotherapy%20and%20oncology&rft.au=Nesvacil,%20Nicole&rft.date=2013-04-01&rft.volume=107&rft.issue=1&rft.spage=20&rft.epage=25&rft.pages=20-25&rft.issn=0167-8140&rft.eissn=1879-0887&rft_id=info:doi/10.1016/j.radonc.2013.01.012&rft_dat=%3Celsevier_pubme%3E1_s2_0_S0167814013000285%3C/elsevier_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/23602372&rft_els_id=1_s2_0_S0167814013000285&rfr_iscdi=true |