Abstract
PURPOSE: To report on first-in-human experience and the initial clinical results using the hybrid applicator Venezia (Elekta, Sweden) in the treatment of patients with locally advanced cervical cancer. MATERIAL AND METHODS: Between March, 2017, and February, 2018, a total of 40 fractions were performed on patients undergoing definitive chemoradiation and brachytherapy (BT) for cervical cancer. A plan comparison was conducted evaluating the hybrid applicator with the clinically used intracavitary and interstitial (IC/IS) BT against a standard plan prescribed to Point A and a manually optimized plan using only intracavitary (IC) BT. Overall 80 treatment plans were retrospectively generated. RESULTS: The clinical use of the hybrid applicator system proved to be feasible in all 40 treatment fractions. The applicator consists of the IC tandem and two lunar-shaped ovoids forming a ring that serves as a template for defined parallel and oblique (12) needle insertion. MRI preplanning was performed the day before the implant. One to six needles were placed per fraction, and overall a total of 66 needles were used. No complications such as bleeding or organ penetration occurred due to needle placement. Significant differences in IC/IS, Point A, and IC plans were derived for dose application to the target volume;D-90 high-risk clinical target volume was 90.7 vs. 88.1 vs. 80.8 Gy (p = 0.008). Likewise, sparing of organs at risk differed significantly for bladder D-2cc, 79.4 vs. 91.8 vs. 79.2 Gy (p = 0.03) and rectum D-2cc, 58.7 vs. 67.3 vs. 62.5 Gy (p = 0.03). CONCLUSION: The clinical application of the Venezia applicator is feasible and allows significantly improved dose coverage while at the same time sufficiently sparing organs at risk.
Dokumententyp: | Zeitschriftenartikel |
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Fakultät: | Medizin |
Themengebiete: | 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit |
ISSN: | 1538-4721 |
Sprache: | Englisch |
Dokumenten ID: | 63836 |
Datum der Veröffentlichung auf Open Access LMU: | 19. Jul. 2019, 12:14 |
Letzte Änderungen: | 04. Nov. 2020, 13:42 |