Simple DVH parameter addition as compared to deformable registration for bladder dose accumulation in cervix cancer brachytherapy

Else Stougård Andersen, Karsten Østergaaard Noe, Thomas Sangild Sørensen, Søren Kynde Nielsen, Fokdal LU, Merete Paludan, Jacob Christian Lindegaard, Kari Tanderup

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

Background and purpose

Variations in organ position, shape, and volume cause uncertainties in dose assessment for brachytherapy (BT) in cervix cancer. The purpose of this study was to evaluate uncertainties associated with bladder dose accumulation based on DVH parameter addition (previously called “the worst case assumption”) in fractionated BT.
Materials and methods

Forty-seven patients treated for locally advanced cervical cancer were included. All patients received EBRT combined with two individually planned 3D image-guided adaptive BT fractions. and were estimated by DVH parameter addition and compared to dose accumulations based on an in-house developed biomechanical deformable image registration (DIR) algorithm.
Results

DIR-based DVH analysis was possible in 42/47 patients. DVH parameter addition resulted in mean dose deviations relative to DIR of 0.4±0.3Gyαβ3 (1.5±1.8%) and 1.9±1.6Gyαβ3 (5.2±4.2%) for and , respectively. Dose deviations greater than 5% occurred in 2% and 38% of the patients for and , respectively. Visual inspection of the dose distributions showed that hotspots were located in the same region of the bladder during both BT fractions for the majority of patients.
Conclusion

DVH parameter addition provides a good estimate for , whereas is less robust to this approximation.
OriginalsprogEngelsk
TidsskriftRadiotherapy & Oncology
Vol/bind107
Nummer1
Sider (fra-til)52-57
Antal sider6
ISSN0167-8140
DOI
StatusUdgivet - 1 apr. 2013

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