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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 1/2014

01-01-2014 | Original article

Volumetric evaluation of an alternative bladder point in brachytherapy for locally advanced cervical cancer

Authors: R. Mazeron, MD, J. Gilmore, MD, J. Champoudry, I. Dumas, J. Helou, MD, P. Maroun, MD, F. Martinetti, PhD, A. Gerbaulet, MD, C. Haie-Meder, MD

Published in: Strahlentherapie und Onkologie | Issue 1/2014

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Abstract

Purpose

To evaluate an alternative dose point, so-called ALG (for Alain Gerbaulet), for the bladder in comparison to the International Commission on Radiation Units and Measurements (ICRU) point and D2cm3 (minimal dose to maximally exposed 2 cm3) in a large cohort of patients with locally advanced cervical cancer treated with external beam radiotherapy followed by image-guided pulsed dose rate brachytherapy.

Methods and materials

For each patient, the ALG point was constructed 1.5 cm above the ICRU bladder, parallel to the tandem (coronal and sagittal planes). The dosimetric data from 162 patients were reviewed.

Results

Average doses to ALG and bladder points were 19.40 Gy ± 7.93 and 17.14 ± 8.70, respectively (p = 0.01). The 2 cm3 bladder dose averaged 24.40 ± 6.77 Gy. Ratios between D2cm3 and dose points were 1.37 ± 0.46 and 1.68 ± 0.74 (p < 0.001) for ALG and ICRU points, respectively. Both dose points appeared correlated with D2cm3 (p < 0.001) with coefficients of determination (R2) of 0.331 and 0.399 respectively. The estimated dose to the ICRU point of the rectum was 12.77 ± 4.21 and 15.76 ± 5.94 for D2cm3 (p < 0.0001). Both values were significantly correlated (p < 0.0001, R2 = 0.485).

Conclusion

The ALG point underestimates the D2cm3, but its mean on a large cohort is closer to D2cm3 than the dose to ICRU point. However, it shows great variability between cases and the weak strength of its correlation to D2cm3 indicates that it is not a good surrogate for individual volumetric evaluation of the dose D2cm3.
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Metadata
Title
Volumetric evaluation of an alternative bladder point in brachytherapy for locally advanced cervical cancer
Authors
R. Mazeron, MD
J. Gilmore, MD
J. Champoudry
I. Dumas
J. Helou, MD
P. Maroun, MD
F. Martinetti, PhD
A. Gerbaulet, MD
C. Haie-Meder, MD
Publication date
01-01-2014
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 1/2014
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-013-0463-6

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