Intracavitary Combined with CT-guided Interstitial Brachytherapy for Locally Advanced Uterine Cervical Cancer: Introduction of the Technique and a Case Presentation
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- WAKATSUKI Masaru
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- OHNO Tatsuya
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- YOSHIDA Daisaku
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- NODA Shin-ei
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- SAITOH Jun-ichi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- SHIBUYA Kei
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- KATOH Hiroyuki
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- SUZUKI Yoshiyuki
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- TAKAHASHI Takeo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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- NAKANO Takashi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine
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Abstract
We report a new technique of brachytherapy consisting of intracavitary combined with computed tomography (CT)-guided interstitial brachytherapy for locally advanced cervical cancer. A Fletcher-Suit applicator and trocar point needles were used for performing high-dose rate brachytherapy under in-room CT guidance. First, a tandem and ovoids were implanted into the patient's vagina and uterus by conventional brachytherapy method. Based on clinical examination and MRI/CT imaging, operating radiation oncologists decided the positions of insertion in the tumor and the depth of the needles from the upper surface of the ovoid. Insertion of the needle applicator was performed from the vaginal vault inside the ovoid within the tumor under CT guidance. In treatment planning, dwell positions and time adaptations within the tandem and ovoids were performed first for optimization based on the Manchester system, and then stepwise addition of dwell positions within the needle was continued. Finally, dwell positions and dwell weights were manually modified until dose-volume constraints were optimally matched. In our pilot case, the dose of D90 to high-risk clinical target volume was improved from 3.5 Gy to 6.1 Gy by using our hybrid method on the dose-volume histogram. D1cc of the rectum, bladder and sigmoid colon by our hybrid method was 4.8 Gy, 6.4 Gy and 3.5 Gy, respectively. This method consists of advanced image-guided brachytherapy that can be performed safely and accurately. This approach has the potential of increasing target coverage, treated volume, and total dose without increasing the dose to organs at risk.
Journal
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- Journal of Radiation Research
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Journal of Radiation Research 52 (1), 54-58, 2011
Journal of Radiation Research Editorial Committee
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Details 詳細情報について
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- CRID
- 1390001205217399424
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- NII Article ID
- 10027418268
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- NII Book ID
- AA00705792
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- ISSN
- 13499157
- 04493060
- http://id.crossref.org/issn/04493060
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- NDL BIB ID
- 10953746
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- Text Lang
- en
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- Data Source
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- JaLC
- NDL
- Crossref
- CiNii Articles
- KAKEN
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- Abstract License Flag
- Disallowed