VMAT VS BRACHYTHERAPY IN GYNECOLOGICAL TUMORS
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Abstract
Background: According to data, gynecological tumors is a big problem for woman health and is second most common cancer in women in the world. Generally, gynecological cancers are being treated with 3D conformal radiotherapy treatment followed by intracavitary brachytherapy treatment.
Purpose: To investigate this question that VMAT could be option for gynecological tumors in some scenarios where some complications making brachytherapy an impossible option like brachytherapy machine is not available in some remote regions, brachytherapy apparatus insertions is not possible due to fibrosis, edema, bleeding and sometime patient is not willing to undergo painful insertion procedure.
Materials and Methods: Ten patients were selected who were treated according to normal workflow treatment with four field EBRT and sequential 3D brachytherapy.
We have chosen the normal scan before the insertion of first brachytherapy and we have delineated the target volumes on the basis of MRI and CT scan reports. We have contoured the organ at risk including bladder, rectum, small bowel and sigmoid colon. Also we have contoured the some target volumes within treatment volume so we can produce the dose gradients in VMAT just like brachytherapy. Then we have planned with VMAT and try to give dose from 85Gy-95Gy to the delineated target with 45Gy in 25 fractions followed by 50.1Gy in 15 fractions. At the end, a comparison of evaluating parameters, including volume coverage, conformity index, homogeneity index and organ doses was made.
Results: We obtained analogous results of target coverage factor and homogeneity index from VMAT and brachytherapy plans. VMAT was really efficient in organ sparing but conformity of brachytherapy is better than VMAT.
Conclusions: On basis of results obtained, it was concluded that VMAT treatment planning should be chosen if brachytherapy is not possible. There are many pros and cons of both techniques but VMAT can be opted in some scenarios as mentioned above.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Imran Raza
Department of Physics & Applied Mathematics, Pakistan Institute of Engineering & Applied Sciences (PIEAS), Nilore, Islamabad 45650, Pakistan.
Ms. Aasia Razzaq
Institute of Nuclear Medicine & Oncology (INMOL), Lahore 10068, Pakistan.
Nauman Amjad
Institute of Nuclear Medicine & Oncology (INMOL), Lahore 10068, Pakistan.
,
Ms. Misbah Batool
Department of Physics & Applied Mathematics, Pakistan Institute of Engineering & Applied Sciences (PIEAS), Nilore, Islamabad 45650, Pakistan.
Dr. M Basim Kakakhel
Department of Physics & Applied Mathematics, Pakistan Institute of Engineering & Applied Sciences (PIEAS), Nilore, Islamabad 45650, Pakistan.
