The impact of inter-fraction changes for perineal template-based interstitial gynecologic brachytherapy implants
Bibliographic record
Abstract
Purpose: Perineal template-based interstitial gynecologic brachytherapy (ISBT) treatments are evaluated to determine whether adaptive inter-fraction re-planning is beneficial and necessary to meet the treatment aims of the American Brachytherapy Society (ABS) consensus guidelines for interstitial brachytherapy.Adherence to the EMBRACE II protocol is also assessed. Material and methods:Ten patients receiving radical intent treatment for locally advanced or recurrent gynecologic malignancies underwent a three-fraction ISBT treatment with an ABS-recommended prescription regimen of 21 to 24 Gy.Clinical treatment plans were created according to a computed tomography (CT) acquired immediately post-implant.The first fraction was delivered on the same day as the implant (Day 1).The remaining two fractions were delivered on the next day (Day 2), at least six hours apart.Prior to treating on Day 2, a verification CT was acquired, permitting assessment of over-night changes.The Day 2 CT was used to evaluate deviations in 2-Gy-per-fraction equivalent dose (EQD 2 ) from the clinically intended dosimetry for clinical target volume (CTV), bladder, rectum, and sigmoid.Results: For all patients, the median (range) difference between the intended and the delivered dosimetry for the CTV D90% was 1.4 Gy 10 (0.3-4.4 Gy 10 ).For all normal tissues, the median (range) difference from the intended normal tissue dose was 2.6 Gy 3 (0.1-15.5 Gy 3 ).In all cases, the deviation from clinically intended dosimetry did not lead to a violation of recommended normal tissue dose guidelines.For two of 10 patients with large normal tissue differences (> 10 Gy 3 from the intended dose), inter-fraction adaptive planning did improve the plan quality, but was not strictly required to meet the normal tissue dose planning aims. Conclusions:The implementation of perineal template-based ISBT treatment without inter-fraction adaptive planning can be delivered to comply with the ABS normal tissue dose guidelines and EMBRACE II limits for prescribed dose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".