Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group☆ (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV

A comparison of organs at risk doses in GYN intracavitary brachytherapy for different tandem lengths and bladder volumes

“…CT images were imported into the TPS. The same radiation oncologist contoured intermediate‐ and high‐risk clinical target volumes (${\text{CTV}}_{\text{IR}}$ and ${\text{CTV}}_{\text{HR}}$) on both empty and full bladder CT image sets of each patient following GEC‐ESTRO recommendations 12 , 13 . This was to minimize uncertainties in contouring which could have a negative impact on our results.…”

“…Dose per fraction was calculated using a biologically equivalent dose of 2 Gy per fraction (EQD2) and linear‐quadratic model with $\alpha /\beta =10\hspace{0.17em}\text{Gy}$ for CTVs and $\alpha /\beta =3\hspace{0.17em}\text{Gy}$ for OARs (2) . GEC‐ESTRO guidelines for contouring and dose constrains on normal tissues and CTVs were observed in treatment planning 12 , 13 , 14 . The treatment aim was to deliver a minimum total dose of 80‐90 Gy to ${\mathrm{D}}_{90}$ of the ${\text{CTV}}_{\text{HR}}$ (EQD2).…”

“…The ${\text{CTV}}_{\text{HR}}$ volume was between 15‐19 cm 3 in all cases. ${\text{CTV}}_{\text{IR}}$ is the volume of tumor at the time of diagnosis or ${\text{CTV}}_{\text{HR}}$ plus GEC‐ESTRO‐recommended margins; we aimed at delivering a dose of 70 Gy EQD2 as ${\mathrm{D}}_{90}$ to ${\text{CTV}}_{\text{IR}}$ 12 , 13 . It follows that the extension of the ${\text{CTV}}_{\text{IR}}$ determined the activation length of the tandem.…”

Brachytherapy treatment planning commissioning: effect of the election of proper bibliography and finite size of TG‐43 input data on standard treatments

“…When taking the GYN GEC ESTRO CTV volume delineation, only in case of voluminous initial disease with poor remission (at brachytherapy start) should the uterus be included in the intermediate risk CTV (31) . In the authors' experience, even in that case, with an active length distribution of 4 cm in the vagina and 5 cm above the cervix, it is uncommon that the tip of the applicator is far enough inside of the CTV that tip ODIN will significantly affect the target dosimetry.…”

Commissioning of a 3D image‐based treatment planning system for high‐dose‐rate brachytherapy of cervical cancer

“…To safely implement 3D image‐based HDR BT for cervical cancer, the European GYN group, Groupe Européen de Curiethérapie (GEC)—European Society for Radiotherapy and Oncology (ESTRO) working group provided several valuable guidelines for 3D image‐based HDR planning. These guidelines focused on target delineation in MRI; 2 , 3 dosimetry, physics tests, and radiation biology; (4) commissioning and applicator reconstruction for plastic applicators; (5) and MRI protocol recommendations for better image acquisition (6) . In addition, the challenges implicit in applicator reconstruction uncertainty were investigated for CT image‐based HDR planning (7) and for 0.3 Tesla (T) open MR scanner planning (8) .…”