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Daily CT measurement of needle applicator displacement during multifractionated high-dose-rate interstitial brachytherapy for postoperative recurrent uterine cancer.

Abstract
We investigated daily needle applicator displacement during multifractionated high-dose-rate interstitial brachytherapy (HDR-ISBT) for postoperative recurrent uterine cancer. Eight patients with postoperative recurrent uterine cancer received HDR-ISBT with or without external beam radiotherapy using our unique ambulatory technique. To analyze displacement, we obtained daily computed tomography (CT) images for 122 flexible needle applicators at 21, 45, 69, and 93 hours after implantation. Displacement was defined as the length between the center of gravity of titanium markers and the needle applicator tips along the daily CT axis. For cases in which displacement was not corrected, we also calculated the dose that covered 90% of the clinical target volume (D90(CTV)) using a dose-volume histogram (DVH). Median caudal needle applicator displacement at 21, 45, 69, and 93 hours was 3, 2, 4, and 5 mm, respectively. More than 15 mm displacement was observed for 2% (2 of 122) and 17% (10 of 60) of needle applicators at 21 and 93 hours, respectively. Cases in which dwell positions were not changed to correct the treatment plan, 2 of 8 patients showed more than 10% reduction in D90(CTV) values compared with the initial treatment plan. Correction of dwell positions of the treatment source improves treatment DVH for multifractionated HDR-ISBT.
AuthorsKen Yoshida, Mari Ueda, Tadashi Takenaka, Hideya Yamazaki, Tadayuki Kotsuma, Kazumasa Aramoto, Shunsuke Miyake, Yukihiro Koretsune, Chiaki Ban, Eiichi Tanaka
JournalJournal of radiation research (J Radiat Res) Vol. 53 Issue 2 Pg. 295-300 ( 2012) ISSN: 1349-9157 [Electronic] England
PMID22240942 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adult
  • Aged
  • Brachytherapy (instrumentation, methods)
  • Dose Fractionation, Radiation
  • Female
  • Humans
  • Middle Aged
  • Needles
  • Neoplasm Recurrence, Local (diagnostic imaging, radiotherapy)
  • Postoperative Care (methods)
  • Prosthesis Implantation
  • Tomography, X-Ray Computed (methods)
  • Treatment Outcome
  • Uterine Neoplasms (diagnostic imaging, therapy)

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