TY - JOUR
T1 - Assessment of the anatomical position of point B and the relationship between point B dose and the dose delivered to pelvic lymph nodes in CT-based high-dose-rate brachytherapy for uterine cervical cancer
AU - Matsukawa, Hideaki
AU - Sasaki, Tomonari
AU - Hirayama, Ryota
AU - Hirose, Taka Aki
AU - Fukunaga, Jun Ichi
N1 - Publisher Copyright:
© 2019 Termedia Publishing House Ltd.. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Purpose: To examine the anatomical position of point B and the relationship between the dose at point B and the dose delivered to the pelvic lymph nodes in computed tomography (CT)-based brachytherapy for cervical cancer. Material and methods: Forty-nine cervical cancer patients were treated at Kyushu University Hospital. For all cases, planning CT images obtained after the applicator insertion were imported to an Oncentra Brachy (Elekta AB, Stockholm, Sweden), and points A (dose prescription, 6 Gy) and points B were set according to the Manchester method. The pelvic lymph node regions (external iliac, internal iliac, and obturator) were contoured, and the anatomic positions of 98 points B in 49 patients were examined. Dose volume histogram (DVH) parameters (D100, D90, D50, D2cc, D1cc, and D0.1cc) were calculated for each lymph node region and compared with the point B dose. Results: The mean bilateral dose to point B was 1.70 ±0.18 Gy, and 26 (27%) of 98 points B were not located in any pelvic lymph node regions. The DVH analysis indicated a low degree of correlation overall, and all values were significantly different from point B doses (p < 0.05), except for D0.1cc of the external iliac node (p = 0.0594) and D1cc of the internal iliac node (p = 0.0711). Conclusions: We investigated the anatomical location of point B in patients with cervical cancer who underwent brachytherapy, and the DVH analysis revealed that the point B dose was a poor surrogate for the dose delivered to the pelvic lymph nodes.
AB - Purpose: To examine the anatomical position of point B and the relationship between the dose at point B and the dose delivered to the pelvic lymph nodes in computed tomography (CT)-based brachytherapy for cervical cancer. Material and methods: Forty-nine cervical cancer patients were treated at Kyushu University Hospital. For all cases, planning CT images obtained after the applicator insertion were imported to an Oncentra Brachy (Elekta AB, Stockholm, Sweden), and points A (dose prescription, 6 Gy) and points B were set according to the Manchester method. The pelvic lymph node regions (external iliac, internal iliac, and obturator) were contoured, and the anatomic positions of 98 points B in 49 patients were examined. Dose volume histogram (DVH) parameters (D100, D90, D50, D2cc, D1cc, and D0.1cc) were calculated for each lymph node region and compared with the point B dose. Results: The mean bilateral dose to point B was 1.70 ±0.18 Gy, and 26 (27%) of 98 points B were not located in any pelvic lymph node regions. The DVH analysis indicated a low degree of correlation overall, and all values were significantly different from point B doses (p < 0.05), except for D0.1cc of the external iliac node (p = 0.0594) and D1cc of the internal iliac node (p = 0.0711). Conclusions: We investigated the anatomical location of point B in patients with cervical cancer who underwent brachytherapy, and the DVH analysis revealed that the point B dose was a poor surrogate for the dose delivered to the pelvic lymph nodes.
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U2 - 10.5114/jcb.2019.84419
DO - 10.5114/jcb.2019.84419
M3 - Article
AN - SCOPUS:85071272406
VL - 11
SP - 137
EP - 145
JO - Journal of Contemporary Brachytherapy
JF - Journal of Contemporary Brachytherapy
SN - 1689-832X
IS - 2
ER -