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Background <p>Radiotherapy along with chemotherapy is the gold standard treatment in locally advanced Ca Cervix, delivered via 3DCRT or newer techniques like IMRT. Although a superior target conformation and normal tissue sparing can be achieved with IMRT, geographical misses and temporal changes in the volumes of the surrounding organs might lead to unpredictable dosimetric changes. These may alter the therapeutic outcomes with reduced local control and increased toxicities. An evaluation of such variations is paramount to modify our treatment strategies in the future.</p> Materials and Methods <p>This prospective study was conducted between January 2021 and August 2022. Locally advanced carcinoma cervix patients were included and planned with IMRT. Kv-CBCTs were taken thrice weekly during the treatment with a strict bladder and rectal protocol. Targets and OARs were contoured on the CBCT. Volumes and doses were calculated in a bias plan.</p> Results <p>Thirty-nine patients were enrolled in this study with 408 CBCT scans taken. Analysis showed that the bladder V35Gy% and V50Gy% had a negative correlation with their respective volumes (<i>r</i> = − 0.08 and − 0.07, respectively) reaching statistical significance for V35Gy% (<i>p</i> &lt; 0.001). The rectal doses were not significantly affected by their filling status but by bladder volumes. A statistically significant negative strong correlation with bladder volume and rectal V50Gy% (<i>r</i> = − 0.64, <i>p</i> ≤ 0.001) was seen.</p> Conclusion <p>In the present study, bladder volume changes had a significant dosimetric impact on the organ and the rectum. Since these volume variations inadvertently impact the late toxicities, the scope of adaptive radiation planning should be further explored.</p>

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Volumetric and Dosimetric Changes in Bladder and Rectum and Target During Intensity-Modulated Radiotherapy in Patients of Locally Advanced Carcinoma Cervix

  • 期刊论文

  • 发表日期：

    2025年1月27日

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  • Sharanya R. Nair,
  • Sweety Gupta,
  • Ajay S. Krishnan,
  • Atokali Chophy,
  • Aviral Rastogi,
  • Ravi Roushan Kumar,
  • R. S. Namitha,
  • Deepa M. Joseph,
  • Manoj Gupta

摘要

Background

Radiotherapy along with chemotherapy is the gold standard treatment in locally advanced Ca Cervix, delivered via 3DCRT or newer techniques like IMRT. Although a superior target conformation and normal tissue sparing can be achieved with IMRT, geographical misses and temporal changes in the volumes of the surrounding organs might lead to unpredictable dosimetric changes. These may alter the therapeutic outcomes with reduced local control and increased toxicities. An evaluation of such variations is paramount to modify our treatment strategies in the future.

Materials and Methods

This prospective study was conducted between January 2021 and August 2022. Locally advanced carcinoma cervix patients were included and planned with IMRT. Kv-CBCTs were taken thrice weekly during the treatment with a strict bladder and rectal protocol. Targets and OARs were contoured on the CBCT. Volumes and doses were calculated in a bias plan.

Results

Thirty-nine patients were enrolled in this study with 408 CBCT scans taken. Analysis showed that the bladder V35Gy% and V50Gy% had a negative correlation with their respective volumes (r = − 0.08 and − 0.07, respectively) reaching statistical significance for V35Gy% (p < 0.001). The rectal doses were not significantly affected by their filling status but by bladder volumes. A statistically significant negative strong correlation with bladder volume and rectal V50Gy% (r = − 0.64, p ≤ 0.001) was seen.

Conclusion

In the present study, bladder volume changes had a significant dosimetric impact on the organ and the rectum. Since these volume variations inadvertently impact the late toxicities, the scope of adaptive radiation planning should be further explored.