Dosimetric Plan Evaluation in Interstitial Brachytherapy for Female Genital Organ Malignancies: A Prospective Observational Study.
DOI:
https://doi.org/10.51168/7pxcy075Cuvinte cheie:
Interstitial brachytherapy, gynecological cancer, dosimetry, high-risk clinical target volumeRezumat
Background:
Interstitial brachytherapy (ISBT) is used for selected gynecological malignancies when conventional intracavitary brachytherapy may provide inadequate target coverage because of bulky, irregular, or anatomically unfavorable disease. This study evaluated the dosimetric quality of ISBT plans with emphasis on target coverage and sparing of organs at risk.
Aim:
To evaluate the dosimetric parameters of interstitial brachytherapy in women with female genital organ malignancies treated at a tertiary care center.
Materials and Methods:
This prospective observational study was conducted at the Department of Radiation Oncology, Indira Gandhi Institute of Medical Sciences, Patna, from January 2024 to December 2025. Thirty women with cervical, vaginal, or vulvar malignancies requiring interstitial brachytherapy were included. Three-dimensional computed tomography-based treatment planning was performed. The high-risk clinical target volume (HR-CTV) and organs at risk, including the bladder, rectum, sigmoid colon, and bowel, were contoured. Dosimetric parameters, including HR-CTV D90, D98, D50, V100, V150, V200, organ-at-risk D2cc, conformity index, homogeneity index, dose non-uniformity ratio, and cumulative equivalent dose in 2-Gy fractions (EQD2), were evaluated.
Results:
The mean age was 54.7 ± 10.8 years. Cervical carcinoma was the most common malignancy (73.3%). Mean HR-CTV D90 was 7.1 ± 0.5 Gy, corresponding to 103.6 ± 6.9% of the prescribed dose, and mean V100 was 94.8 ± 3.7%. Twenty-seven patients (90.0%) achieved HR-CTV D90 ≥100%. Mean cumulative bladder, rectal, and sigmoid D2cc EQD2 values were 78.4 ± 8.6, 67.2 ± 6.9, and 64.8 ± 7.1 Gy, respectively. No grade ≥3 acute gastrointestinal or genitourinary toxicity was observed.
Conclusion:
Three-dimensional image-guided ISBT provided satisfactory target coverage with acceptable organ-at-risk doses.
Recommendation:
Larger prospective studies with longer follow-up are recommended to evaluate long-term toxicity and oncological outcomes
Referințe
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Copyright (c) 2026 Dr. Satya Kumar, Dr. Nandlal Yadawa, Dr. Santosh Kumar, Dr. Rajesh Kumar Singh, Dr. Seema Devi
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