Direction modulated brachytherapy (DMBT) for treatment of cervical cancer: A planning study with <sup>192</sup>Ir, <sup>60</sup>Co, and <sup>169</sup>Yb HDR sources
Notice bibliographique
Résumé
Purpose To evaluate plan quality of a novel MRI‐compatible direction modulated brachytherapy (DMBT) tandem applicator using 192 Ir, 60 Co, and 169 Yb HDR brachytherapy sources, for various cervical cancer high‐risk clinical target volumes (CTV HR ). Materials and Methods The novel DMBT tandem applicator has six peripheral grooves of 1.3‐mm diameter along a 5.4‐mm thick nonmagnetic tungsten alloy rod. Monte Carlo (MC) simulations were used to benchmark the dosimetric parameters of the 192 Ir, 60 Co, and 169 Yb HDR sources in a water phantom against the literature data. 45 clinical cases that were treated using conventional tandem‐and‐ring applicators with 192 Ir source ( 192 Ir‐T&R) were selected consecutively from int E rnational M RI‐guided BRA chytherapy in CE rvical cancer (EMBRACE) trial. Then, for each clinical case, 3D dose distribution of each source inside the DMBT and conventional applicators were calculated and imported onto an in‐house developed inverse planning optimization code to generate optimal plans. All plans generated by the DMBT tandem‐and‐ring (DMBT T&R) from all three sources were compared to the respective 192 Ir‐T&R plans. For consistency, all plans were normalized to the same CTV HR D90 achieved in clinical plans. The D 2 cm3 for organs at risk (OAR) such as bladder, rectum, and sigmoid, and D90, D98, D10, V100, and V200 for CTV HR were calculated. Results In general, plan quality significantly improved when a conventional tandem (Con.T) is replaced with the DMBT tandem. The target coverage metrics were similar across 192 Ir‐T&R and DMBT T&R plans with all three sources ( P > 0.093). 60 Co‐DMBT T&R generated greater hot spots and less dose homogeneity in the target volumes compared with the 192 Ir‐ and 169 Yb‐DMBT T&R plans. Mean OAR doses in the DMBT T&R plans were significantly smaller ( P < 0.0084) than the 192 Ir‐T&R plans. Mean bladder D 2 cm3 was reduced by 4.07%, 4.15%, and 5.13%, for the 192 Ir‐, 60 Co‐, and 169 Yb‐DMBT T&R plans respectively. Mean rectum (sigmoid) D 2 cm3 was reduced by 3.17% (3.63%), 2.57% (3.96%), and 4.65% (4.34%) for the 192 Ir‐, 60 Co‐, and 169 Yb‐DMBT T&R plans respectively. The DMBT T&R plans with the 169 Yb source generally resulted in the greatest OAR sparing when the CTV HR were larger and irregular in shape, while for smaller and regularly shaped CTV HR (<30 cm 3 ), OAR sparing between the sources were comparable. Conclusions The DMBT tandem provides a promising alternative to the Con.T design with significant improvement in the plan quality for various target volumes. The DMBT T&R plans generated with the three sources of varying energies generated superior plans compared to the conventional T&R applicators. Plans generated with the 169 Yb‐DMBT T&R produced best results for larger and irregularly shaped CTV HR in terms of OAR sparing. Thus, this study suggests that the combination of the DMBT tandem applicator with varying energy sources can work synergistically to generate improved plans for cervical cancer brachytherapy.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».