| Yan Chuanjun,Wang Xianliang,Wen Aiping,et al.Dosimetric analysis of the optimization algorithm for intracavitary/interstitial brachytherapy of cervical cancer[J].Chinese Journal of Radiological Medicine and Protection,2023,43(7):524-531 |
| Dosimetric analysis of the optimization algorithm for intracavitary/interstitial brachytherapy of cervical cancer |
| Received:January 10, 2023 |
| DOI：10.3760/cma.j.cn112271-20230110-00009 |
| KeyWords:Cervical cancer|Intracavitary/interstitial brachytherapy|Equivalent uniform biologically effective dose|Tumor control probability|Normal tissue complication |
| FundProject:四川省科技计划资助项目(2022YFG0194,2022YFS0047,2021YFG0320,2020YJ0446);肿瘤医工创新基金(ZYGX2021YGCX002) |
| Author Name | Affiliation | E-mail | | Yan Chuanjun | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | | | Wang Xianliang | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | | | Wen Aiping | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | | | Luo Jingyue | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | | | Wang Pei | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | | | Li Jie | Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Department of Radiotherapy of Sichuan Cancer Center, Radiation Oncology Key Laboratory of Sichuan Province, Chengdu 610042, China | jie.li@yeah.net |
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| Abstract:: |
| Objective To provide a basis for selecting the optimization method for intracavitary/interstitial brachytherapy (IC/ISBT) of cervical cancer by comparing graphical optimization (GO), inverse planning simulated annealing (IPSA), and hybrid inverse planning optimization (HIPO) using dosimetric and radiobiological models. Methods This study selected 65 patients with cervical cancer who were treated with image-guided IC/ISBT. The afterloading therapy plans for these patients were optimized using GO, IPSA, and HIPO individually, with a prescription dose high-risk clinical target volume (HRCTV) D90 of 6 Gy. The non-parametric Friedman test and the non-parametric Wilcoxon rank test were employed to analyze the differences in duration, dose-volume parameters, and radiobiology between the three types of optimized plans. Results Inverse planning optimization (IPSA: 46.53 s; HIPO: 98.36 s) took less time than GO (135.03 s). In terms of gross target volume (GTV) dose, the high-dose irradiation V150% (53.66%) was slightly higher in the HIPO-optimized plans, while the V200% (30.29%) was higher in the GO-optimized plans. The GO-optimized plans had a higher conformity index (CI; 0.91) than other plans, showing statistically significant differences. Compared with other plans, the HIPO-optimized plans showed the lowest doses of D1 cm3 and D2 cm3 at bladders and rectums and non-statistically significant doses at small intestines (P ＞ 0.05). In terms of the equivalent uniform biologically effective dose (EUBED) for HRCTV, the HIPO-optimized plans showed a higher value (12.35 Gy) than the GO-optimized plans (12.23 Gy) and the IPSA-optimized plans (12.13 Gy). Moreover, the EUBED at bladders was the lowest (2.38 Gy) in the GO-optimized plans, the EUBED at rectums was the lowest (3.74 Gy) in the HIPO-optimized plans, and the EUBED at small intestines was non-significantly different among the three types of optimized plans (P = 0.055). There was no significant difference in the tumor control probability (TCP) predicted using the three types of optimized plans (P ＞ 0.05). The normal tissue complication probabilities (NTCPs) of bladders and rectums predicted using the HIPO-optimized plans were lower than those predicted using the GO- and IPSA-optimized plans(χ2 ＝ 12.95-38.43, P < 0.01), and the NTCP of small intestines did not show significant differences (P ＞ 0.05). Conclusions Among the three types of optimization algorithms, inverse optimization takes less time than GO. GO-optimized plans are more conformal than IPSA- and HIPO-optimized plans. HIPO-optimized plans can increase the biological coverage dose of the target volume and reduce the maximum physical/biological exposure and NTCP at bladders and rectums. Therefore, HIPO is recommended preferentially as an optimization algorithm for IC/ISBT for cervical cancer. |
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