Use of 3D planning of HDR brachytherapy in patients with cervical cancer

Abstract

Background. Combined radiation therapy is the «gold standard» for the treatment of stages IIB-IVA of cervical cancer (cervical cancer). Given the data of statistical indicators of cervical cancer, the study of new approaches to treatment and implementation in clinical practice of modern technologies of radiation therapy of widespread cervical cancer is an extremely important area. Purpose – evaluate the benefits of using CT topometric preparation in planning brachytherapy for cervical cancer. Materials and Methods. 3D planning of brachytherapy of 24 patients with locally advanced cervical cancer (FIGO IIIB stage), who underwent a radical program of combined radiation therapy (remote radiation therapy with chemical modification with cisplatin followed by HDR-brachytherapy (High dose rate brachytherapy)). Results. The paper presents the results of the analysis of differences in brachytherapy planning according to orthogonal images and CT images. The analysis of the influence of the constitutional features of patients revealed that there are differences in the topographic anatomy of the pelvis depending on the surface area of the body. In patients with a body surface area of up to 1,65 m2 , a more intimate fit of the intestine to the target volume of irradiation was noted. No similar planning difficulties were found in patients with a body surface area above 1,65 m2 . Conclusions. The use of 3D images in the planning of intracavitary irradiation in patients with cervical cancer provides precision brachytherapy by simultaneously visualizing the irradiated volumes and spatial relationships of the anatomical structures of the pelvis, the introduced endostats and the corresponding volumetric dose distributions.