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Comparative Study
. 2025 Sep 23;66(5):528-534.
doi: 10.1093/jrr/rraf042.

Comparison of rectal and bladder dose between retractor insertion and gauze packing in intracavitary brachytherapy for cervical cancer

Noriko Osaki  1   2 , Takashi Soyano  2 , Shinya Sutani  2 , Hideki Matsumoto  2 , Atsuya Takeda  3 , Atsunori Yorozu  2
Affiliations
Comparative Study

Comparison of rectal and bladder dose between retractor insertion and gauze packing in intracavitary brachytherapy for cervical cancer

Noriko Osaki et al. J Radiat Res. .

Abstract

This study aimed to compare and verify the rectal and bladder doses of intracavitary brachytherapy (ICBT) using both rectal retractor (RR) and gauze packing (GP) in the same patients. A total of 37 patients who underwent ICBT using RR and GP for cervical cancer were included in this study. Rectal and bladder dose and volume data were compared with the RR and GP treatments in the same patients and the confounding factors were examined. When comparing RR and GP, the median and interquartile ranges for rectal D2cc were 2.8 (2.5-3.7) Gy with RR and 3.2 (2.7-3.8) Gy with GP. The median bladder D2cc was 4.9 (4.5-6.3) Gy with RR and 4.8 (3.9-5.4) Gy with GP. The Wilcoxon signed-rank test revealed that rectal doses were significantly lower with RR (P = 0.02), whereas bladder doses were significantly higher with RR (P < 0.001). Analysis of the correlation between the number of gauze pieces and the difference in rectal D2cc between GP and RR using Pearson's distribution revealed no significant correlation (R = -0.20, P = 0.22), as well as bladder D2cc between GP and RR also revealed no significant correlation (R = -0.20, P = 0.22). The number of gauze pieces did not necessarily correlate with a reduction in the rectal and bladder dose. In conclusion, rectal D2cc was lower with RR in image-guided brachytherapy for cervical cancer, whereas bladder D2cc was higher with RR than with GP.

Keywords: cervical cancer; gauze packing; intracavitary brachytherapy; rectal retractor.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Patient selection. IC/IS BT, intracavitary and interstitial brachytherapy; RR, rectal retractor.
Fig. 2
Fig. 2
(a) D2cc of the rectum of individuals. RD2cc, D2cc of rectum; RR, rectal retractor; GP, gauze packing. (b) D2cc of the bladder for each individual. BD2cc, D2cc of the bladder; RR, rectal retractor; GP, gauze packing.
Fig. 3
Fig. 3
Axial and sagittal of computed tomography (CT) images of the same patient. (a) CT images taken during treatment with RR (RD2cc: 3.3 Gy, BD2cc: 5.8 Gy). (b) CT images taken during treatment with GP (RD2cc: 3.8 Gy, BD2cc: 3.3 Gy). RD2cc, D2cc of rectum; BD2cc, D2cc of the bladder; RR, rectal retractor; GP, gauze packing.
See this image and copyright information in PMC

References

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