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UNIVERSITY OF BUCHAREST
FACULTY OF PHYSICS Guest
2025-07-06 14:06 |
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Conference: Bucharest University Faculty of Physics 2025 Meeting
Section: Biophysics; Medical Physics
Title:
Benefits of hybrid intracavitary–interstitial HDR brachytherapy compared to intracavitary HDR brachytherapy in the definitive radiotherapy of cervical cancer
Authors:
Anca-Ștefania ORIAN (1), Mihai SUDITU (2), Radu Alin VASILACHE (1)
Affiliation:
1) University of Bucharest, Faculty of Physics, 405 Atomiștilor Street, P.O. Box MG-11, 077125 Magurele, Romania
2) Amethyst Centre Bucharest, Strada Odăii 42, 075100 Otopeni, Romania
E-mail
orian.anca@yahoo.com
Keywords:
Cervical cancer, HDR brachytherapy, hybrid technique, interstitial needles, 3D planning, radiotherapy, organs at risk, image-guided brachytherapy
Abstract:
Hybrid intracavitary–interstitial high-dose-rate (HIIC HDR) brachytherapy has emerged as an advanced solution in the treatment of locally advanced cervical cancer, particularly for large, asymmetric, or laterally extended tumors. This study aimed to evaluate the dosimetric advantages of the HIIC approach compared to conventional intracavitary (IC) HDR brachytherapy, based on treatment plans for a cohort of ten patients. Each patient underwent external beam radiotherapy (EBRT) with a standard dose of 45 Gy, followed by two brachytherapy planning scenarios: IC alone and HIIC using the Geneva applicator system with interstitial needles. Treatment plans were created using Oncentra Brachy v4.6 and CT-based planning images acquired with Siemens Somatom go.SIM. Comparative dosimetric analysis focused on D90 (CTV_HR), D 2cm³ for organs at risk (OARs), and EQD2 values. Results showed that HIIC achieved a higher mean D90 (88.91 Gy) compared to IC (79.04 Gy), improving target coverage in all patients. According to EMBRACE recommendations (D90 > 85 Gy), only 4 patients met this threshold using IC, while all 10 met it with HIIC, and 3 exceeded 90 Gy. At the same time, doses to OARs remained within acceptable limits for both techniques, with HIIC providing slightly better or comparable sparing in EQD2_Total for bladder, rectum, sigmoid, and small bowel. These findings support the use of hybrid brachytherapy to optimize dose distribution and improve tumor control while maintaining organ sparing, particularly in anatomically challenging cases. Despite its increased complexity, HIIC offers meaningful clinical benefits and should be considered in the definitive radiotherapy of cervical cancer.
References:
Thomadsen, B. & Miller, R. Brachytherapy Physics. Comprehensive Biomedical Physics 9, 315–381 (2014).
Pötter, R. et al. Recommendations from gynaecological (GYN) GEC ESTRO working group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy - 3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology. Radiotherapy and Oncology 78, 67–77 (2006).
Yavaş, G. TURKISH JOURNAL of ONCOLOGY Dose Rate Definition in Brachytherapy. J Oncol 34, 44–55 (2019).
Limbergen, E. Van et al. PART I: THE BASICS OF BRACHYTHERAPY 5 Radiobiology of LDR, HDR, PDR and VLDR Brachytherapy The GEC ESTRO Handbook of Brachytherapy Editors.
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