Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers

Michelina Casale; Lorena Draghini; Fabio Trippa; Sara Costantini; Lisa Vicenzi; Letizia Tesei; Alessandro Di Marzo; Fabio Arcidiacono; Marco Italiani; Ernesto Maranzano

doi:10.5114/jcb.2022.121175

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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5/2022
vol. 14

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abstract:

Original paper

Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers

Michelina Casale

¹

,

Lorena Draghini

¹

,

Fabio Trippa

¹

,

Sara Costantini

¹

,

Lisa Vicenzi

²

,

Letizia Tesei

²

,

Alessandro Di Marzo

¹

,

Fabio Arcidiacono

¹

,

Marco Italiani

¹

,

Ernesto Maranzano

^{1, 3}

Radiotherapy Oncology Centre, Santa Maria Hospital, Terni, Italy
Radiation Oncology Centre, Ospedali Riuniti Umberto I, Ancona, Italy
Department of Medicine and Surgery, University of Perugia, Italy

J Contemp Brachytherapy 2022; 14, 5: 470–475

DOI: https://doi.org/10.5114/jcb.2022.121175

Online publish date: 2022/11/15

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AMA

Casale M, Draghini L, Trippa F, et al. Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers. Journal of Contemporary Brachytherapy. 2022;14(5):470-475. doi:10.5114/jcb.2022.121175.

APA

Casale, M., Draghini, L., Trippa, F., Costantini, S., Vicenzi, L.,  & Tesei, L. et al. (2022). Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers. Journal of Contemporary Brachytherapy, 14(5), 470-475. https://doi.org/10.5114/jcb.2022.121175

Chicago

Casale, Michelina, Lorena Draghini, Fabio Trippa, Sara Costantini, Lisa Vicenzi, Letizia Tesei,  and Alessandro Di Marzo et al. 2022. "Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers". Journal of Contemporary Brachytherapy 14 (5): 470-475. doi:10.5114/jcb.2022.121175.

Harvard

Casale, M., Draghini, L., Trippa, F., Costantini, S., Vicenzi, L., Tesei, L., Di Marzo, A., Arcidiacono, F., Italiani, M.,  and Maranzano, E. (2022). Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers. Journal of Contemporary Brachytherapy, 14(5), pp.470-475. https://doi.org/10.5114/jcb.2022.121175

MLA

Casale, Michelina et al. "Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers." Journal of Contemporary Brachytherapy, vol. 14, no. 5, 2022, pp. 470-475. doi:10.5114/jcb.2022.121175.

Vancouver

Casale M, Draghini L, Trippa F, Costantini S, Vicenzi L, Tesei L et al. Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers. Journal of Contemporary Brachytherapy. 2022;14(5):470-475. doi:10.5114/jcb.2022.121175.

Purpose
To evaluate the reliability of algebraic sum with respect to rigid fusion of treatment plans related to adjuvant external beam pelvic radiotherapy (APR) and vaginal cuff high-dose-rate brachytherapy (BT) in uterine cancer patients.

Material and methods
For algebraic sum, APR and BT doses were mathematically added. Rigid fusion was realized overlapping computed tomography (CT) images of APR and BT treatment plans. Rectum and bladder were considered reference organs at risk (OARs). Following dose (D) parameters were examined: Dmax (0.5 cc), D20% and D50% for rectum, Dmax (0.5 cc) and D50% for bladder; for each parameter, differences between the two adopted methods were reported as Δ-values.

Results
Twenty uterine cancer patients submitted to radical surgery followed by APR plus vaginal cuff BT were reviewed. APR was done with a dose of 25 × 2 Gy. All patients also receveid a vaginal cuff boost with BT at the dose of 2 × 5 Gy. Differences between mean cumulative doses calculated with rigid fusion and algebraic sum were evaluated. For the rectum and bladder ΔD50%, there were no significant differences, and BT contribution resulted minimal. An apparent significant difference value was registered in bladder ΔDmax (0.5 cc). No toxicity was observed.

Conclusions
In uterine cancer patients submitted to APR and vaginal cuff BT, algebraic sum and rigid plan fusion of doses allowed to obtain similar results in evaluating cumulative OARs’ doses. Further investigations and increased number of patients are recommended to confirm our findings.

keywords:

Reliability of algebraic sum to evaluate adjuvant pelvic radiotherapy and vaginal cuff brachytherapy cumulative doses in uterine cancers

Michelina Casale 1 , Lorena Draghini 1 , Fabio Trippa 1 , Sara Costantini 1 , Lisa Vicenzi 2 , Letizia Tesei 2 , Alessandro Di Marzo 1 , Fabio Arcidiacono 1 , Marco Italiani 1 , Ernesto Maranzano 1, 3

brachytherapy, uterine cancer, pelvic radiotherapy, treatment plan fusion, algebraic sum, rigid fusion

Michelina Casale

¹

,

Lorena Draghini

¹

,

Fabio Trippa

¹

,

Sara Costantini

¹

,

Lisa Vicenzi

²

,

Letizia Tesei

²

,

Alessandro Di Marzo

¹

,

Fabio Arcidiacono

¹

,

Marco Italiani

¹

,

Ernesto Maranzano

^{1, 3}