ecancermedicalscience

Research

IMRT and brachytherapy comparison in gynaecological cancer treatment: thinking over dosimetry and radiobiology

17 Dec 2019
Valentina Pinzi, Valeria Landoni, Federica Catani, Roberta Lazzari, Barbara Alicja Jereczek-Fossa, Roberto Orecchia

Background: The role of radiotherapy and brachytherapy in the management of locally advanced cervical and endometrial cancer is well established. However, in some cases, intracavitary brachytherapy (ICBRT) is not recommended or cannot be carried out. We aimed to investigate whether external-beam irradiation delivered by means of intensity-modulated radiation therapy (IMRT) might replace ICBRT in gynaecological cancer when the standard ICBRT boost delivering cannot be administered for technical or clinical reasons.

Materials and methods: Fifteen already delivered treatments for gynaecological cancer patients were analysed. The treatments were performed through 3-dimensional conformal radiotherapy (3D-CRT) to the whole-pelvis up to the dose of 45–50.4 Gy followed by a boost dose administered with ICBRT in high-dose-rate or pulsed-dose-rate modality. For each patient, IMRT plans were elaborated to mimic the ICBRT. We analysed the ICBRT boost versus IMRT boost in terms of dosimetric and radiobiological aspects.

Results: Mean conformity index value calculated on boost volume was 0.73 for ICBRT and 0.97 for IMRT. Mean conformation number was 0.24 for ICBRT boost and 0.78 for IMRT boost. Mean normal tissue complication probability (NTCP) values for 3D-CRT plus ICBRT and for IMRT (pelvis plus boost) were, respectively, 28% and 5% for rectum; 1.5% and 0.1% for urinary bladder and 8.9% and 6.1% for bowel.

Conclusions: Our findings suggest that IMRT may represent a viable alternative in delivering the boost in patients diagnosed with gynaecological cancer not amenable to ICBRT.

Related Articles

Deevyashali Parekh, Ansy H Patel, Areeb Khan, Eloho Olojakpoke, Ashay Karpe, Zoya Peelay, Vijay Patil
Pambinkavil Sivaraman Raji, Anitha Thomas, Vinotha Thomas, Anjana Joel, Dhanya Susan Thomas, Rachel G Chandy, Ajit Sebastian, Abraham Peedicayil
Tooba Ali, Laraib Khan, Bilal Mazhar Qureshi, Asim Hafiz, Maria Tariq, Khurram Minhas, Nasir Ali, Ahmed Nadeem Abbasi
Solomon Kibudde, Awusi Kavuma, Bonny Abal, Moses Fredrick Katumba, Cissy Bangidde Namutale, Daniel Kanyike, Israel Luutu
Abideen A Olayiwola, Yusuf A Oshodi, Oluwarotimi I Akinola, Adekunbiola A Banjo, Kabiru A Rabiu, Ayokunle M Olumodeji
Beatrice P Mushi, Summaiya Haddadi, Alita Mrema, Jerry Ndumbalo, Nanzoke Mvungi, Msiba Selekwa, Julius Mwaiselage, Larry Akoko, Yona Ringo, Rohan Luhar, Rebecca DeBoer, Katherine Van Loon, Elia Mmbaga, Geoffrey C Buckle