Real-time dose-rate monitoring with gynecologic brachytherapy: Results of an initial clinical trial

Belley, Matthew D.; Craciunescu, Oana; Chang, Zheng; Langloss, Brian W.; Stanton, Ian N.; Yoshizumi, Terry T.; Therien, Michael J.; Chino, Junzo

doi:10.1016/j.brachy.2018.07.014

Cited by 22 publications

(25 citation statements)

References 29 publications

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“…Few studies have used IVD during HDR-VBT. The aim of IVD was mostly for real-time dose-rate monitoring and dose verification for quality assurance purposes [ 29 , 30 , 31 ]. One study used IVD to measure the actual dose to the rectum during HDR-VBT and compared it to the rectal dose as determined by the treatment planning system (TPS); the mean dose discrepancy was 2.2 Gy [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

et al. 2021

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(1) Background: Postoperative vaginal-cuff HDR interventional radiotherapy (brachytherapy) is a standard treatment in early-stage endometrial cancer. This study reports the effect of in vivo dosimetry-based biological planning for two different fractionation schedules on the treatment-related toxicities. (2) Methods: 121 patients were treated. Group A (82) received 21 Gy in three fractions. Group B (39) received 20 Gy in four fractions. The dose was prescribed at a 5 mm depth or to the applicator surface according to the distance between the applicator and the rectum. In vivo dosimetry measured the dose of the rectum and/or urinary bladder. With a high measured dose, the dose prescription was changed from a 5 mm depth to the applicator surface. (3) Results: The median age was 66 years with 58.8 months mean follow-up. The dose prescription was changed in 20.7% of group A and in 41% of group B. Most toxicities were grade 1–2. Acute urinary toxicities were significantly higher in group A. The rates of acute and late urinary toxicities were significantly higher with a mean bladder dose/fraction of >2.5 Gy and a total bladder dose of >7.5 Gy. One patient had a vaginal recurrence. (4) Conclusions: Both schedules have excellent local control and acceptable rates of toxicities. Using in vivo dosimetry-based biological planning yielded an acceptable dose to the bladder and rectum.

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Section: Discussionmentioning

confidence: 99%

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

et al. 2021

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“…For this setup, the standard error of the mean is equal to 50% of the standard deviation. This dose difference is in the range of published uncertainties for in vivo dosimetry in HDR brachytherapy [2,12]. Finally, all ten fractions of the clinical HDR plan were consecutively delivered, amounting to a dose of at least 300 Gy to the surface of the applicator, and the applicator was monitored for structural damage.…”

Section: Testing and Validationmentioning

confidence: 99%

A design process for a 3D printed patient-specific applicator for HDR brachytherapy of the orbit

et al. 2020

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Background: This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. Case presentation: A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of reirradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient's skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. Conclusions: Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

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“…For this setup, the standard error of the mean is equal to 50% of the standard deviation. This dose difference is in the range of published uncertainties for in vivo dosimetry in HDR brachytherapy (Mason et al 2016;Belley et al 2018). Finally, all ten fractions of the clinical HDR plan were consecutively delivered, amounting to a dose of at least 300 Gy to the surface of the applicator, and the applicator was monitored for structural damage.…”

Section: Testing and Validationmentioning

confidence: 99%

A Design Process for a 3D Printed Patient-Specific Applicator for HDR Brachytherapy of the Orbit

Subashi

Jacobs

Hood

et al. 2020

Preprint

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Abstract BACKGROUND: This report describes a process for designing a 3D printed patient-specific applicator for HDR brachytherapy of the orbit. CASE PRESENTATION: A 34-year-old man with recurrent melanoma of the orbit was referred for consideration of re-irradiation. An applicator for HDR brachytherapy was designed based on the computed tomography (CT) of patient anatomy. The body contour was used to generate an applicator with a flush fit against the patient’s skin while the planning target volume (PTV) was used to devise channels that allow for access and coverage of the tumor bed. An end-to-end dosimetric test was devised to determine feasibility for clinical use. The applicator was designed to conform to the volume and contours inside the orbital cavity. Support wings placed flush with the patient skin provided stability and reproducibility, while 16 source channels of varying length were needed for sufficient access to the target. A solid sheath, printed as an outer support-wall for each channel, prevented bending or accidental puncturing of the surface of the applicator. CONCLUSIONS: Quality assurance tests demonstrated feasibility for clinical use. Our experience with available 3D printing technology used to generate an applicator for the orbit may provide guidance for how materials of suitable biomechanical and radiation properties can be used in brachytherapy.

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Real-time dose-rate monitoring with gynecologic brachytherapy: Results of an initial clinical trial

Cited by 22 publications

References 29 publications

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

Biological Planning of Radiation Dose Based on In Vivo Dosimetry for Postoperative Vaginal-Cuff HDR Interventional Radiotherapy (Brachytherapy)

A design process for a 3D printed patient-specific applicator for HDR brachytherapy of the orbit

A Design Process for a 3D Printed Patient-Specific Applicator for HDR Brachytherapy of the Orbit

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