Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix

Background: The inclusion of pelvic lymph node (PLN) metastasis in the FIGO staging system has impacted disease classification and patient survival. Brachytherapy is a key component in managing carcinoma cervix; however, the dose contribution of brachytherapy to PLNs remains unclear. Aims and Obj...

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Main Authors: Deepak Sharma, Amrut S Kadam, Ramashish Kumar, Raghavendra BK, Srihari G, Perpetua Shruthi A, Varun Chandra
Format: Article
Language:English
Published: Manipal College of Medical Sciences, Pokhara 2024-12-01
Series:Asian Journal of Medical Sciences
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Online Access:https://www.nepjol.info/index.php/AJMS/article/view/69957
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author Deepak Sharma
Amrut S Kadam
Ramashish Kumar
Raghavendra BK
Srihari G
Perpetua Shruthi A
Varun Chandra
author_facet Deepak Sharma
Amrut S Kadam
Ramashish Kumar
Raghavendra BK
Srihari G
Perpetua Shruthi A
Varun Chandra
author_sort Deepak Sharma
collection DOAJ
description Background: The inclusion of pelvic lymph node (PLN) metastasis in the FIGO staging system has impacted disease classification and patient survival. Brachytherapy is a key component in managing carcinoma cervix; however, the dose contribution of brachytherapy to PLNs remains unclear. Aims and Objectives: This study aims to quantify the dose contribution of high-dose rate (HDR) brachytherapy to individual pelvic nodal groups. Materials and Methods: We included 40 biopsy-proven carcinoma cervix patients, stages IIA to IVA. All patients underwent external beam radiotherapy (EBRT) with concurrent cisplatin chemotherapy, followed by HDR brachytherapy, either intracavitary brachytherapy (ICBT) or interstitial brachytherapy (ISBT). A total dose of 21 Gy in 3 fractions (7 Gy per fraction) was prescribed to the high-risk clinical target volume. Results: For ICBT, the mean absolute doses received by the external iliac, internal iliac, and obturator groups were 0.56 Gy, 1.02 Gy, and 1.22 Gy, corresponding to EQD2 (α/β=10) values of 0.49 Gy, 0.93 Gy, and 1.14 Gy, respectively. In the ISBT group, the mean absolute doses were 0.49 Gy, 0.86 Gy, and 1.11 Gy, with corresponding EQD2s of 0.43 Gy, 0.85 Gy, and 1.02 Gy. Conclusion: PLNs received significant dose contributions from HDR brachytherapy in cervical cancer patients, providing valuable reference data for determining the EBRT boost dose in cases of enlarged PLNs.
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spelling doaj-art-d541d2352be6422b92c9804d3dbcfc782024-12-05T06:36:10ZengManipal College of Medical Sciences, PokharaAsian Journal of Medical Sciences2467-91002091-05762024-12-011512176180https://doi.org/10.3126/ajms.v15i12.69957Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervixDeepak Sharma 0https://orcid.org/0009-0004-6971-616XAmrut S Kadam 1https://orcid.org/0000-0002-7835-5317Ramashish Kumar 2https://orcid.org/0009-0008-4568-4684Raghavendra BK 3https://orcid.org/0009-0006-8705-6489Srihari G 4https://orcid.org/0009-0005-8393-2210Perpetua Shruthi A 5https://orcid.org/0009-0003-0819-0574Varun Chandra 6https://orcid.org/0009-0004-2601-3368Senior Resident, Department of Radiation Oncology, Lady Hardinge Medical College, New Delhi, India Professor, Department of Radiation Oncology, Victoria Hospital, Bengaluru Medical College and Research Institute, Karnataka, India Senior Resident, Department of Radiation Oncology, Lady Hardinge Medical College, New Delhi, India Senior Resident, Department of Radiation Oncology, Hassan Institute of Medical Sciences, Sri Chamarajendra District Hospital, Hassan, Karnataka, India Senior Resident, Department of Radiation Oncology, Karnataka Medical College and Research Institute, Hubballi (KMC-RI, Hubballi), Karnataka, India Registrar, HCG Cancer Centre, KR Road, Bengaluru, Karnataka, India Junior Resident, Department of Radiation Oncology, Victoria Hospital, Bengaluru Medical College and Research Institute, Karnataka, India Background: The inclusion of pelvic lymph node (PLN) metastasis in the FIGO staging system has impacted disease classification and patient survival. Brachytherapy is a key component in managing carcinoma cervix; however, the dose contribution of brachytherapy to PLNs remains unclear. Aims and Objectives: This study aims to quantify the dose contribution of high-dose rate (HDR) brachytherapy to individual pelvic nodal groups. Materials and Methods: We included 40 biopsy-proven carcinoma cervix patients, stages IIA to IVA. All patients underwent external beam radiotherapy (EBRT) with concurrent cisplatin chemotherapy, followed by HDR brachytherapy, either intracavitary brachytherapy (ICBT) or interstitial brachytherapy (ISBT). A total dose of 21 Gy in 3 fractions (7 Gy per fraction) was prescribed to the high-risk clinical target volume. Results: For ICBT, the mean absolute doses received by the external iliac, internal iliac, and obturator groups were 0.56 Gy, 1.02 Gy, and 1.22 Gy, corresponding to EQD2 (α/β=10) values of 0.49 Gy, 0.93 Gy, and 1.14 Gy, respectively. In the ISBT group, the mean absolute doses were 0.49 Gy, 0.86 Gy, and 1.11 Gy, with corresponding EQD2s of 0.43 Gy, 0.85 Gy, and 1.02 Gy. Conclusion: PLNs received significant dose contributions from HDR brachytherapy in cervical cancer patients, providing valuable reference data for determining the EBRT boost dose in cases of enlarged PLNs.https://www.nepjol.info/index.php/AJMS/article/view/69957brachytherapy; mean absolute dose; pelvic lymph nodes; carcinoma cervix
spellingShingle Deepak Sharma
Amrut S Kadam
Ramashish Kumar
Raghavendra BK
Srihari G
Perpetua Shruthi A
Varun Chandra
Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
Asian Journal of Medical Sciences
brachytherapy; mean absolute dose; pelvic lymph nodes; carcinoma cervix
title Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
title_full Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
title_fullStr Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
title_full_unstemmed Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
title_short Assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
title_sort assessment of dose contribution to pelvic lymph nodes in patients undergoing brachytherapy for carcinoma cervix
topic brachytherapy; mean absolute dose; pelvic lymph nodes; carcinoma cervix
url https://www.nepjol.info/index.php/AJMS/article/view/69957
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