The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer

Authors

William M. Rocky, University of Iowa
Sudershan K. Bhatia, University of Iowa
Geraldine M. Jacobson, West Virginia University
Yusung Kim, West Virginia University

Author ORCID Identifier

N/A

https://orcid.org/0000-0003-2760-531X

https://orcid.org/0000-0002-1737-221X

https://orcid.org/0000-0002-8528-4465

Document Type

Article

Publication Date

2013

College/Unit

School of Medicine

Department/Program/Center

Radiation Oncology

Abstract

Purpose: We perform a clinical retrospective study to determine whether a vaginal balloon-packing system provides a dosimetric reduction to organs at risk (OARs) versus traditional gauze packing for gynecological high-dose-rate brachytherapy (HDR-BT). We also test various balloon filling materials for optimizing imaging quality.

Material and methods: Filling materials for balloon-packing were evaluated based on imaging quality with X-ray, computerized tomography, and magnetic resonance imaging modalities. We then retrospectively reviewed 45 HDR-BT plans of 18 patients performed with gauze packing and 39 plans of 16 patients performed with balloon-packing. Twelve patients received both gauze and balloon-packing. HDR-BT was delivered with an iridium-192 afterloader and a Fletcher-Suit-Declos-style T&O applicator. At each fraction, 3D imaging was obtained. The D2_cc values of OARs were calculated, as well as ICRU-defined point doses.

Results: In the 84 HDR fractions reviewed, vaginal balloon-packing provides statistically equivalent doses to rectum, bladder, and sigmoid compared to gauze packing. On average balloon-packing produced average reductions of 3.3% and 6.9% in the rectal and sigmoid D2_ccdoses and an increase of 3.2% to the bladder D2_cc dose (normalized to prescription dose), although none of these values were statistically significant for the twelve patients who received both gauze and balloon-packing (32 and 40 total fractions, respectively).

Conclusions: In the 84 HDR fractions analyzed, vaginal balloon-packing is as effective as gauze packing for dose sparing to the rectum, bladder, and sigmoid. A 1 : 1 solution of saline and contrast for filling material enables easy contouring for image-guided HDR with minimal artefacts.

Digital Commons Citation

Rocky, William M.; Bhatia, Sudershan K.; Jacobson, Geraldine M.; and Kim, Yusung, "The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer" (2013). Faculty & Staff Scholarship. 2669.
https://researchrepository.wvu.edu/faculty_publications/2669

Source Citation

Rockey, W., Bhatia, S., Jacobson, G., & Kim, Y. (2013). Original paper
The dosimetric impact of vaginal balloon-packing on intracavitary high-dose-rate brachytherapy for gynecological cancer. Journal of Contemporary Brachytherapy, 5(1), 17-22. https://doi.org/10.5114/jcb.2013.34449

Comments

© 2013 Termedia Sp. z o. o. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (http://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.