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. 2014 Apr 25;48(2):203-9.
doi: 10.2478/raon-2013-0082. eCollection 2014 Jun.

Inter-application displacement of brachytherapy dose received by the bladder and rectum of the patients with inoperable cervical cancer

Goran Marosevic  1 , Dzenita Ljuca  2 , Hasan Osmic  3 , Semir Fazlic  3 , Oliver Arsovski  1 , Dusan Mileusnic  1
Affiliations

Inter-application displacement of brachytherapy dose received by the bladder and rectum of the patients with inoperable cervical cancer

Goran Marosevic et al. Radiol Oncol. .

Abstract

Background: The aim of the study was to examine on the CT basis the inter-application displacement of the positions D0.1cc, D1cc and D2cc of the brachytherapy dose applied to the bladder and rectum of the patients with inoperable cervical cancer.

Patients and methods: This prospective study included 30 patients with cervical cancer who were treated by concomitant chemo-radiotherapy. HDR intracavitary brachytherapy was made by the applicators type Fletcher tandem and ovoids. For each brachytherapy application the position D0.1cc was determined of the bladder and rectum that receive a brachytherapty dose. Then, based on the X, Y, and Z axis displacement, inter-application mean X, Y, and Z axis displacements were calculated as well as their displacement vectors (R). It has been analyzed whether there is statistically significant difference in inter-application displacement of the position of the brachytherapy dose D0.1cc, D1cc and D2cc of the bladder and rectum. The ANOVA test and post-hoc analysis by Tukey method were used for testing statistical importance of differences among the groups analyzed. The difference among the groups analyzed was considered significant if p < 0.05.

Results: There are significant inter-application displacements of the position of the brachytherapy dose D0,1cc, D1cc and D2cc of the bladder and rectum.

Conclusions: When we calculate the cumulative brachytherapy dose by summing up D0,1cc, D1cc and D2cc of the organs at risk for all the applications, we must bear in mind their inter-application displacement, and the fact that it is less likely that the worst scenario would indeed happen.

Keywords: brachytherapy; inoperable cervical cancer; inter-application variations.

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Figures

FIGURE 1.
FIGURE 1.
The mean values of the inter-application X, Y, and Z axis displacements of the brachytherapy dose on the bladder for each application in relation to the first one. Also, the figure shows the differences between every fraction individually. The results are given in centimetres (cm).
FIGURE 2.
FIGURE 2.
Absolute displacements, that is the vector of inter fraction displacements of the brachytherapy dose on the bladder given in centimetres for every fraction in relation to the first one, which is presented by the centre of the co-ordinate system.
FIGURE 3.
FIGURE 3.
The mean values of the inter-application X, Y, and Z axis displacements of the brachytherapy dose on the rectum for each application in relation to the first one. Also, the figure shows the differences between every fraction individually. The results are given in centimetres (cm).
FIGURE 4.
FIGURE 4.
Absolute displacement that is the vector of interfraction displacements of the brachytherapy dose on the rectum given in centimetres for every fraction in relation to the first one, which is presented by the centre of the co-ordinate system.
See this image and copyright information in PMC

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