Comparison of manual and inverse optimization for CT guided interstitial brachytherapy in locallyadvanced cervical cancer
10.3760/cma.j.issn.1004-4221.2017.11.010
- VernacularTitle:CT引导下局部晚期宫颈癌组织间插植BT正向与逆向治疗计划比较
- Author:
Xia LIN
1
;
Zhongshan LIU
;
Jiapeng WANG
;
Jie GUO
;
Shuangchen LU
;
Ling QIU
;
Hongyong WANG
;
Yunfeng LI
;
Xiaojun REN
;
Tiejun WANG
Author Information
1. 吉林大学第二医院放疗科
- Keywords:
Cervical cancer;
Interstitial brachytherapy;
Inverse planning simulated annealing;
Isodose manual optimized method;
Dosimetr
- From:
Chinese Journal of Radiation Oncology
2017;26(11):1288-1291
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the dosimetric difference between inverse planning simulated annealing(IPSA)and manual optimized plan for isodose line in interstitial brachytherapy for locally advanced cervical cancer and to provide a better optimization method for clinical application. Methods A total of 104 patients with cervical cancer were enrolled in this study. They received pelvic external beam radiotherapy and interstitial brachytherapy in five fractions. Both IPSA and manual optimized plan for isodose line were used to optimize the dose in each fraction. Dose volume parameters of the two plans were compared to analyze the dosimetric outcome by paired t-test. Results There were no significant differences in mean D 90and D 100for high-risk clinical target volume(HR-CTV)and D 90for intermediate-risk clinical target volume(IR-CTV)between the two groups(P>0.05). The IPSA group had a significantly higher D 100for IR-CTV than the manual optimized group(58.36±2.06 Gy vs. 53.99±2.17 Gy, P=0.025). For organs at risk,the IPSA group had a significantly lower mean rectum D 2ccand a significantly higher bladder D 2ccthan the manual optimized group(68.53± 2.85 Gy vs. 71.77± 1.79 Gy, P=0.002;80.49± 3.36 Gy vs. 78.71± 2.64 Gy,P=0.034). There was no significant difference in sigmoid D 2ccbetween the two groups(P>0.05). The IPSA group had significantly higher relative dose homogeneity index(HI)and conformity index (CI)of radiation dose for target volume than the manual optimized group(P<0.05), and there was no significant difference in overdose volume index(OI)between the two groups(P= 0. 1 0 7).Conclusions Compared with manual optimized plan for isodose line, IPSA can improve the dose distribution of tumor tissue,reduce mean rectum D 2cc,and increase CI and HI,so it is a preferable optimized treatment planning method in clinical application.
