The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy

Antonio L. Damato, Ivan Buzurovic, Mandar S. Bhagwat, Robert A. Cormack, Phillip M. Devlin, Scott Friesen, Jorgen Hansen, Larissa J. Lee, Matthias M. Manuel, Linda P. Cho, Desmond O'Farrell, Akila Viswanathan

Research output: Contribution to journalArticle

Abstract

Purpose To investigate the dose–volume histogram metrics and optimization results of the contoured bowel in cervical cancer brachytherapy. Methods and Materials Treatment plans of cervical cancer patients treated with image-guided high dose rate were retrospectively analyzed with institutional review board approval. In addition to the clinical target volume, rectum, bladder, and sigmoid, the bowel was contoured at the time of planning (Group 1) or at the time of this analysis (Group 2). Results Thirty-two patients treated with 145 insertions were included. Before optimization, mean ± 1 standard deviation overall bowel minimum dose to the most irradiated 2 cm3 volume of an organ (D2cc) was 67.8 Gyα/β3 ± 13.7 Gyα/β3 (Group 1: 72.6 ± 13.2 Gyα/β3; Group 2: 57.3 ± 8.0 Gyα/β3). Before optimization, one patient in Group 1 presented a bowel D2cc metric exceeding 100 Gyα/β3. After optimization, bowel D2cc mean ± 1 standard deviation was 59.4 ± 6.7 Gyα/β3 (Group 1: 61.4 ± 6.0 Gyα/β3, p < 0.001; Group 2: 55.2 ± 6.5 Gyα/β3, p = 0.026). Conclusions Given the potentially high doses and the benefit of optimization in reducing dose to the organs at risk, we recommend consideration of systematic contouring of the bowel when bowel is present in the pelvis.

Original languageEnglish (US)
Pages (from-to)579-585
Number of pages7
JournalBrachytherapy
Volume16
Issue number3
DOIs
StatePublished - May 1 2017

Fingerprint

Brachytherapy
Uterine Cervical Neoplasms
Organs at Risk
Organ Size
Research Ethics Committees
Sigmoid Colon
Pelvis
Rectum
Urinary Bladder
Therapeutics

Keywords

  • Bowel
  • Cervical cancer
  • Contouring

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy. / Damato, Antonio L.; Buzurovic, Ivan; Bhagwat, Mandar S.; Cormack, Robert A.; Devlin, Phillip M.; Friesen, Scott; Hansen, Jorgen; Lee, Larissa J.; Manuel, Matthias M.; Cho, Linda P.; O'Farrell, Desmond; Viswanathan, Akila.

In: Brachytherapy, Vol. 16, No. 3, 01.05.2017, p. 579-585.

Research output: Contribution to journalArticle

Damato, AL, Buzurovic, I, Bhagwat, MS, Cormack, RA, Devlin, PM, Friesen, S, Hansen, J, Lee, LJ, Manuel, MM, Cho, LP, O'Farrell, D & Viswanathan, A 2017, 'The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy', Brachytherapy, vol. 16, no. 3, pp. 579-585. https://doi.org/10.1016/j.brachy.2017.01.008
Damato, Antonio L. ; Buzurovic, Ivan ; Bhagwat, Mandar S. ; Cormack, Robert A. ; Devlin, Phillip M. ; Friesen, Scott ; Hansen, Jorgen ; Lee, Larissa J. ; Manuel, Matthias M. ; Cho, Linda P. ; O'Farrell, Desmond ; Viswanathan, Akila. / The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy. In: Brachytherapy. 2017 ; Vol. 16, No. 3. pp. 579-585.
@article{352290219e514c03b9b2dc89cc940200,
title = "The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy",
abstract = "Purpose To investigate the dose–volume histogram metrics and optimization results of the contoured bowel in cervical cancer brachytherapy. Methods and Materials Treatment plans of cervical cancer patients treated with image-guided high dose rate were retrospectively analyzed with institutional review board approval. In addition to the clinical target volume, rectum, bladder, and sigmoid, the bowel was contoured at the time of planning (Group 1) or at the time of this analysis (Group 2). Results Thirty-two patients treated with 145 insertions were included. Before optimization, mean ± 1 standard deviation overall bowel minimum dose to the most irradiated 2 cm3 volume of an organ (D2cc) was 67.8 Gyα/β3 ± 13.7 Gyα/β3 (Group 1: 72.6 ± 13.2 Gyα/β3; Group 2: 57.3 ± 8.0 Gyα/β3). Before optimization, one patient in Group 1 presented a bowel D2cc metric exceeding 100 Gyα/β3. After optimization, bowel D2cc mean ± 1 standard deviation was 59.4 ± 6.7 Gyα/β3 (Group 1: 61.4 ± 6.0 Gyα/β3, p < 0.001; Group 2: 55.2 ± 6.5 Gyα/β3, p = 0.026). Conclusions Given the potentially high doses and the benefit of optimization in reducing dose to the organs at risk, we recommend consideration of systematic contouring of the bowel when bowel is present in the pelvis.",
keywords = "Bowel, Cervical cancer, Contouring",
author = "Damato, {Antonio L.} and Ivan Buzurovic and Bhagwat, {Mandar S.} and Cormack, {Robert A.} and Devlin, {Phillip M.} and Scott Friesen and Jorgen Hansen and Lee, {Larissa J.} and Manuel, {Matthias M.} and Cho, {Linda P.} and Desmond O'Farrell and Akila Viswanathan",
year = "2017",
month = "5",
day = "1",
doi = "10.1016/j.brachy.2017.01.008",
language = "English (US)",
volume = "16",
pages = "579--585",
journal = "Brachytherapy",
issn = "1538-4721",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - The value of systematic contouring of the bowel for treatment plan optimization in image-guided cervical cancer high-dose-rate brachytherapy

AU - Damato, Antonio L.

AU - Buzurovic, Ivan

AU - Bhagwat, Mandar S.

AU - Cormack, Robert A.

AU - Devlin, Phillip M.

AU - Friesen, Scott

AU - Hansen, Jorgen

AU - Lee, Larissa J.

AU - Manuel, Matthias M.

AU - Cho, Linda P.

AU - O'Farrell, Desmond

AU - Viswanathan, Akila

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Purpose To investigate the dose–volume histogram metrics and optimization results of the contoured bowel in cervical cancer brachytherapy. Methods and Materials Treatment plans of cervical cancer patients treated with image-guided high dose rate were retrospectively analyzed with institutional review board approval. In addition to the clinical target volume, rectum, bladder, and sigmoid, the bowel was contoured at the time of planning (Group 1) or at the time of this analysis (Group 2). Results Thirty-two patients treated with 145 insertions were included. Before optimization, mean ± 1 standard deviation overall bowel minimum dose to the most irradiated 2 cm3 volume of an organ (D2cc) was 67.8 Gyα/β3 ± 13.7 Gyα/β3 (Group 1: 72.6 ± 13.2 Gyα/β3; Group 2: 57.3 ± 8.0 Gyα/β3). Before optimization, one patient in Group 1 presented a bowel D2cc metric exceeding 100 Gyα/β3. After optimization, bowel D2cc mean ± 1 standard deviation was 59.4 ± 6.7 Gyα/β3 (Group 1: 61.4 ± 6.0 Gyα/β3, p < 0.001; Group 2: 55.2 ± 6.5 Gyα/β3, p = 0.026). Conclusions Given the potentially high doses and the benefit of optimization in reducing dose to the organs at risk, we recommend consideration of systematic contouring of the bowel when bowel is present in the pelvis.

AB - Purpose To investigate the dose–volume histogram metrics and optimization results of the contoured bowel in cervical cancer brachytherapy. Methods and Materials Treatment plans of cervical cancer patients treated with image-guided high dose rate were retrospectively analyzed with institutional review board approval. In addition to the clinical target volume, rectum, bladder, and sigmoid, the bowel was contoured at the time of planning (Group 1) or at the time of this analysis (Group 2). Results Thirty-two patients treated with 145 insertions were included. Before optimization, mean ± 1 standard deviation overall bowel minimum dose to the most irradiated 2 cm3 volume of an organ (D2cc) was 67.8 Gyα/β3 ± 13.7 Gyα/β3 (Group 1: 72.6 ± 13.2 Gyα/β3; Group 2: 57.3 ± 8.0 Gyα/β3). Before optimization, one patient in Group 1 presented a bowel D2cc metric exceeding 100 Gyα/β3. After optimization, bowel D2cc mean ± 1 standard deviation was 59.4 ± 6.7 Gyα/β3 (Group 1: 61.4 ± 6.0 Gyα/β3, p < 0.001; Group 2: 55.2 ± 6.5 Gyα/β3, p = 0.026). Conclusions Given the potentially high doses and the benefit of optimization in reducing dose to the organs at risk, we recommend consideration of systematic contouring of the bowel when bowel is present in the pelvis.

KW - Bowel

KW - Cervical cancer

KW - Contouring

UR - http://www.scopus.com/inward/record.url?scp=85013883958&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85013883958&partnerID=8YFLogxK

U2 - 10.1016/j.brachy.2017.01.008

DO - 10.1016/j.brachy.2017.01.008

M3 - Article

C2 - 28256433

AN - SCOPUS:85013883958

VL - 16

SP - 579

EP - 585

JO - Brachytherapy

JF - Brachytherapy

SN - 1538-4721

IS - 3

ER -