Which technique is better for planning parametrial boost for cervical carcinoma? A dosimetric comparison study about new radiotherapy techniques vs classic method.
A dosimetric comparison about new radiotherapy techniques
Keywords:
Cervical carcinoma, radiotherapy, parametrial boost, simultaneous integrated boost, radiotherapy techniques.Abstract
Aim: The idea of this study was based on the question of which technique should be used to plan parametrial boost in clinics that treat cervical carcinoma with external beam radio therapy (EBRT), but send their patients to other centers for brachytherapy, and who wishes to prepare all EBRT plan before brachytherapy.
Material & method: Intensity Modulated Radiotherapy (IMRT), Volumetric Arc Therapy (Vmat) and Antero-Posterior (AP-PA) plans with Simultaneous Integrated Boost (SIB) or sequential boost of 10 patients target volume and organ at risk doses were evaluated. Forty-five Gy were administered for the pelvis and 54 Gy were administered for the parametrium.
Result: The conformity and homogeneity indexes were found to be better in SIB for both the pelvis and the parametrial volumes. In the evaluation of V45and V54in the rectum and the bladder, it was observed that the SIB plain was statistically significantly lower (p=0.01, p<0.001, p=0.02, p<0.01 respectively), and for the V54AP-PA plan was higher than the others (p<0.01 for both rectum and bladder).
Conclusion: SIB is considered to be a preferable method due to better CI, HI, dose coverage and lower normal tissue tolerance doses than the other techniques. Sequential boost can be applied in patients where a higher daily pelvic dose is desired.
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