Optimization of HDRBT boost dose delivery for patients with rectal cancer.

Boost Dose optimization Double-balloon Health tissue spearing Inoperable patients Iridium-192 Multichannel applicator Papillon legacy Rectal cancer Shielding

Journal

Brachytherapy
ISSN: 1873-1449
Titre abrégé: Brachytherapy
Pays: United States
ID NLM: 101137600

Informations de publication

Date de publication:
Historique:
received: 13 10 2018
revised: 31 01 2019
accepted: 11 02 2019
pubmed: 28 3 2019
medline: 25 1 2020
entrez: 28 3 2019
Statut: ppublish

Résumé

We describe methods to improve dose delivery for patients with rectal cancer receiving boost brachytherapy after external beam radiotherapy. Patients with rectal cancer who were ineligible or refusing surgery are treated with external beam radiotherapy and subsequently with three weekly image-guided volume-adapted high-dose-rate brachytherapy boosts of 10 Gy to the residual clinical target volume, for a total of 30 Gy in three fractions. Tungsten shielding placed at the center of intracavitary mold applicator and double-balloon technique was used to improve dose conformity to the target. Our results show that the use of tungsten shield and double balloon reduces the dose gradient within the target volume to receive the prescription boost dose of 10 Gy from maximum dose of 60 Gy down to 20 Gy. We outlined two methods for achieving higher high-dose-rate brachytherapy dose conformity using the tungsten shielding rods (to spare contralateral healthy tissues) and double-balloon technique (to decrease dose gradient within the target to minimize dose to the proximal mucosa).

Identifiants

pubmed: 30914225
pii: S1538-4721(18)30672-X
doi: 10.1016/j.brachy.2019.02.001
pii:
doi:

Substances chimiques

Tungsten V9306CXO6G

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

559-563

Informations de copyright

Copyright © 2019 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Slobodan Devic (S)

Radiation Oncology Department, Jewish General Hospital, Montreal, Quebec, Canada; Medical Physics Unit, McGill University, Montreal, Quebec, Canada; Oncology Department, McGill University, Montreal, Quebec, Canada; Segal Cancer Centre, Jewish General Hospital, McGill University, Montréal, Quebec, Canada. Electronic address: slobodan.devic@mcgill.ca.

Hamed Bekerat (H)

Radiation Oncology Department, Jewish General Hospital, Montreal, Quebec, Canada; Medical Physics Unit, McGill University, Montreal, Quebec, Canada; Segal Cancer Centre, Jewish General Hospital, McGill University, Montréal, Quebec, Canada.

Aurelie Garant (A)

Oncology Department, McGill University, Montreal, Quebec, Canada.

Te Vuong (T)

Radiation Oncology Department, Jewish General Hospital, Montreal, Quebec, Canada; Oncology Department, McGill University, Montreal, Quebec, Canada; Segal Cancer Centre, Jewish General Hospital, McGill University, Montréal, Quebec, Canada.

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