Five-year DFS of 62% and 45% of Stage II and III patients treated under routine care represents comparable stage-matched results to the rest of the world, respectively.
The purpose is to compare CT-based dosimetry with International Commission on Radiation Units and Measurements (ICRU 38) bladder and rectum reference points in patients of carcinoma of uterine cervix treated with intracavitary brachytherapy (ICA). Twenty-two consecutive patients were evaluated. Orthogonal radiographs and CT images were acquired and transferred to PLATO planning system. Bladder and rectal reference points were identified according to ICRU 38 recommendations. Dosimetry was carried out based on Manchester system. Patient treatment was done using 192Iridium high dose rate (HDR) remote after-loading machine based on the conventional radiograph-based dosimetry. ICRU rectal and bladder point doses from the radiograph plans were compared with D2, dose received by 2 cm3 of the organ receiving maximum dose from CT plan. V2, volume of organ receiving dose more than the ICRU reference point, was evaluated. The mean (±standard deviation) volume of rectum and bladder was 60 (±28) cm3 and 138 (±41) cm3 respectively. The mean reference volume in radiograph and CT plan was 105 (±7) cm3 and 107 (±7) cm3 respectively. It was found that 6 (±4) cm3 of rectum and 16 (±10) cm3 of bladder received dose more than the prescription dose. V2 of rectum and bladder was 7 (±1.7) cm3 and 20.8 (±6) cm3 respectively. Mean D2 of rectum and bladder was found to be 1.11 (±0.2) and 1.56 (±0.6) times the mean ICRU reference points respectively. This dosimteric study suggests that comparison of orthogonal X-ray-based and CT-based HDR ICA planning is feasible. ICRU rectal point dose correlates well with maximum rectal dose, while ICRU bladder point underestimates the maximum bladder dose.
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