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Purpose <p>To evaluate the spatial and dosimetric differences between traditional applicator-based point A and anatomically defined point A in cervical cancer brachytherapy.</p> Materials and Methods <p>Thirty cervical cancer patients post-external beam radiotherapy underwent ICBT HDR brachytherapy. CT simulation was performed in arterial (15–30&#xa0;s), venous (2&#xa0;min), and delayed (8&#xa0;min) phases. Anatomical point A was identified at the intersection of the uterine artery (arterial phase) and ureter (delayed phase). 7&#xa0;Gy was prescribed to applicator-based point A, and the spatial relationship between both points was analysed.</p> Results <p>Anatomical point A was superior in 40% and inferior in 60% of cases. The mean distances from applicator-based point A were: right side—1.1&#xa0;cm superior, 1.38&#xa0;cm inferior, 1.71&#xa0;cm lateral, 1.9&#xa0;cm anterior, 0.91&#xa0;cm posterior; left side—0.81&#xa0;cm superior, 1.33&#xa0;cm inferior, 1.76&#xa0;cm lateral, 1.07&#xa0;cm anterior, 0.34&#xa0;cm posterior. Applicator-based point A was inside the uterus in 50% of cases, at the uterine wall in 27%, and outside in 23%. Anatomical point A was always extrauterine. When prescribing to applicator-based point A, anatomical point A received 48% less dose, while applicator-based point A received 128% more when prescribed to anatomical point A (<i>p</i> &lt; 0.05).</p> Conclusions <p>Point A needs to be redefined, and further studies are required to establish consensus on the prescription point in ICBT HDR, emphasising the preference and feasibility of volume-based planning.</p>

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Comparison of Applicator-Based Point A and Anatomical Point A in Terms of Position and Dosimetry in Intracavitary Brachytherapy (ICBT) for Carcinoma Cervix Patients

  • 期刊论文

  • 发表日期：

    2025年6月7日

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  • H. B. Govardhan,
  • Ibrahim Khaleel,
  • Lalitha Nageshwari. S,
  • Rahul Thirugnanam,
  • M. V. Manjula,
  • Y. S. Pawar,
  • S. Shivamma,
  • Vatsal Desai

摘要

Purpose

To evaluate the spatial and dosimetric differences between traditional applicator-based point A and anatomically defined point A in cervical cancer brachytherapy.

Materials and Methods

Thirty cervical cancer patients post-external beam radiotherapy underwent ICBT HDR brachytherapy. CT simulation was performed in arterial (15–30 s), venous (2 min), and delayed (8 min) phases. Anatomical point A was identified at the intersection of the uterine artery (arterial phase) and ureter (delayed phase). 7 Gy was prescribed to applicator-based point A, and the spatial relationship between both points was analysed.

Results

Anatomical point A was superior in 40% and inferior in 60% of cases. The mean distances from applicator-based point A were: right side—1.1 cm superior, 1.38 cm inferior, 1.71 cm lateral, 1.9 cm anterior, 0.91 cm posterior; left side—0.81 cm superior, 1.33 cm inferior, 1.76 cm lateral, 1.07 cm anterior, 0.34 cm posterior. Applicator-based point A was inside the uterus in 50% of cases, at the uterine wall in 27%, and outside in 23%. Anatomical point A was always extrauterine. When prescribing to applicator-based point A, anatomical point A received 48% less dose, while applicator-based point A received 128% more when prescribed to anatomical point A (p < 0.05).

Conclusions

Point A needs to be redefined, and further studies are required to establish consensus on the prescription point in ICBT HDR, emphasising the preference and feasibility of volume-based planning.