Seeing is saving: the benefit of 3D imaging in gynecologic brachytherapy. Gynecol Oncol 2015 Jul;138(1):207-15
Date
03/10/2015Pubmed ID
25748646DOI
10.1016/j.ygyno.2015.02.025Scopus ID
2-s2.0-84931567063 (requires institutional sign-in at Scopus site) 29 CitationsAbstract
Despite a concerning decline in the use of brachytherapy over the past decade, no other therapy is able to deliver a very high dose of radiation into or near a tumor, with a rapid fall-off of dose to adjacent structures. Compared to traditional X-ray-based brachytherapy that relies on points, the use of CT and MR for 3D planning of gynecologic brachytherapy provides a much more accurate volume-based calculation of dose to an image-defined tumor and to the bladder, rectum, sigmoid, and other pelvic organs at risk (OAR) for radiation complications. The publication of standardized guidelines and an online contouring teaching atlas for performing 3D image-based brachytherapy has created a universal platform for communication and training. This has resulted in a uniform approach to using image-guided brachytherapy for treatment and an internationally accepted format for reporting clinical outcomes. Significant improvements in survival and reductions in toxicity have been reported with the addition of image guidance to increase dose to tumor and decrease dose to the critical OAR. Future improvements in individualizing patient treatments should include a more precise definition of the target. This will allow dose modulation based on the amount of residual disease visualized on images obtained at the time of brachytherapy.
Author List
Viswanathan AN, Erickson BAAuthor
Beth A. Erickson MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BrachytherapyFemale
Genital Neoplasms, Female
Humans
Imaging, Three-Dimensional
Radiotherapy Planning, Computer-Assisted
