Late Rectal Complications Evaluated by Computed Tomography–Based Dose Calculations in Patients With Cervical Carcinoma Undergoing High-Dose-Rate Brachytherapy

Three-Dimensional Imaging in Gynecologic Brachytherapy: A Survey of the American Brachytherapy Society

“…The correlation between CT-defined rectal dose and toxicity was described by Noda et al (8) Women who had a higher rectal dose had a higher incidence of rectal bleeding. Whether the D0.1cc or the D2cc may be more valuable in predicting normal tissue complications is not known.…”

“…Several centers have reported the use of CT-based imaging for tandem and ring or ovoid (7)(8)(9)(10)(11)(12)(13)(14), interstitial (15)(16)(17)(18), or vaginal cylinder (19) cases. The use of MRI for gynecologic brachytherapy has been reported in the U.S. (16) and in Europe (20)(21)(22)(23).…”

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

“…By mirroring BT fractionation experience while respecting dosimetric/volumetric constraints (73), an established BED (associated with a specific outcome) can guide the selection of optimum SBRT/IMRT dose/ fractionation schedule. Yet, such correlation is hard to define: While Petereit et al could not relate the BED at Point A with either pelvic control or toxicity (74), other investigators demonstrated excessive toxicity as rectal BED 3 exceeded certain threshold [>125 Gy 3 for rectal point (75,76) or >140 Gy 3 for rectal maximum dose (77)]. Similar association between LC/toxicity and BED could not be elucidated based on the current SBRT/IMRT boost studies.…”

Rectal Dose and Source Strength of the High-Dose-Rate Iridium-192 Both Affect Late Rectal Bleeding After Intracavitary Radiation Therapy for Uterine Cervical Carcinoma

“…Many studies using ICRU RP (12,13) or DVH parameters in HDR-ICBT have indicated that a higher rectal dose is significantly related with rectal bleeding. Noda et al (14), using a CT-based rectal mucosal point dose, showed that a rectal BED $140 Gy 3 was associated with a significantly greater frequency of rectal complications, and Koom et al (15) found that several DVH parameters obtained from three-dimensional CTbased treatment planning or ICRU RP are significantly associated with endoscopic scoring of mucosal changes in the rectum. However, these reports of CT-based DVH analysis results show only the relationship between rectal dose and rectal bleeding but do not deal with the power of the source.…”