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01-06-2014 | Original article

Robotic radiosurgery as an alternative to brachytherapy for cervical cancer patients

Authors: Oliver Neumann, Anne Kluge, Ph. D., Olga Lyubina, M. D., Waldemar Wlodarczyk, Ph. D., Ulrich Jahn, Ph. D., Christhardt Köhler, M. D., Volker Budach, M. D., Markus Kufeld, M. D., Simone Marnitz, M. D.

Published in: Strahlentherapie und Onkologie | Issue 6/2014

Abstract

Background and purpose

To compare MRI-guided brachytherapy (BT) and two different dose prescriptions for robotic radiosurgery (RRS) in locally advanced cervical cancer.

Methods and materials

Eleven patients with FIGO stage IIB–IIIB cervical cancer underwent RRS instead of BT for various reasons. A total dose of 30 Gy was administered in five fractions. The maximum dose was chosen such that the prescribed dose was 70 % of the maximum dose (RRS₇₀). To simulate BT more closely, additional plan calculations were carried out for a higher maximum dose with the same enclosing dose of 30 Gy being now 25 % of the maximum dose (RRS₂₅). BT plans were calculated for the same patients (BT_RRS). Finally, the resulting three sets of treatment plans were compared with 38 other patients treated with MRI-guided BT and the same dose prescription (BT_ref). Plan comparisons were performed based on DVH parameters with regard to target coverage (V100), conformation number (CN), and sparing of the organs at risk (OARs).

Results

The best coverage of V100 = 100 ± 0 % was obtained with RRS₂₅, followed by RRS₇₀ with 97.1 ± 2.7 %, BT_ref with 90.9 ± 8.9 %, and the intraindividual BT_RRS with 80.6 ± 6.4 %. The sparing of OARs was associated with D0.1 cc, D2 cc, and D5 cc to the rectum, sigmoid, and bladder walls. OAR doses were compliant with the GEC-ESTRO guidelines and comparable among RRS₇₀, RRS₂₅, BT_RRS, and BT_ref. By contrast, RRS₂₅ could not fulfill these guidelines, exceeding considerably the tolerable dose constraints for the walls of the critical OARs.

Conclusion

Despite of the excellent coverage and higher maximum dose, the unacceptably high exposure to the OARs disqualified RRS₂₅ as an alternative for BT in cervical cancer patients. By contrast, RRS₇₀ offered the best protection for the OARs, comparable to BT, and even better target coverage and conformity than BT.

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Title: Robotic radiosurgery as an alternative to brachytherapy for cervical cancer patients
Authors: Oliver Neumann
Anne Kluge, Ph. D.
Olga Lyubina, M. D.
Waldemar Wlodarczyk, Ph. D.
Ulrich Jahn, Ph. D.
Christhardt Köhler, M. D.
Volker Budach, M. D.
Markus Kufeld, M. D.
Simone Marnitz, M. D.
Publication date: 01-06-2014
Publisher: Springer Berlin Heidelberg
Published in: Strahlentherapie und Onkologie / Issue 6/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0614-4

ACC 2024 Congress

Springer Medicine

Robotic radiosurgery as an alternative to brachytherapy for cervical cancer patients

Abstract

Background and purpose

Methods and materials

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Background and purpose

Methods and materials

Results

Conclusion

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