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The effect of leg position on the dose distribution of intracavitary brachytherapy for cervical cancer: 3D computerised tomography plan evaluation and in vivo dosimetric study

Published online by Cambridge University Press:  20 May 2016

Mustafa Cengiz ,
Fatma Colak ,
Demet Yildiz ,
Ali Dogan ,
Gokhan Ozyigit ,
Ferah Yildiz  and
Murat Gurkaynak
Mustafa Cengiz*
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Fatma Colak
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Demet Yildiz
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Ali Dogan
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Gokhan Ozyigit
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Ferah Yildiz
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
Murat Gurkaynak
Affiliation:
Department of Radiation Oncology, Hacettepe University, Ankara, Turkey
*
Correspondence to: Mustafa Cengiz, Faculty of Medicine, Department of Radiation Oncology, Hacettepe University, 06100 Sihhiye, Ankara, Turkey. E-mail: mcengiz@hacettepe.edu.tr
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Abstract

Purpose

To evaluate the impact of leg position on the dose distribution during intracavitary brachytherapy for cervical cancer.

Patients and methods

This prospective study was performed on 11 women with cervical cancer who underwent intracavitary brachytherapy. After insertion of the brachytherapy applicator, two sets of computed tomography slices were taken including pelvis, one with straight leg and one with leg flexion position with knee support. The dose (7 Gy) was prescribed to point A. The radiotherapy plan was run on the Plato Planning Software System V14·1 to get the dose distributions. Also, rectum and bladder doses were measured for both leg positions during the treatment. The doses and volumes of organs were compared via the Wilcoxon signed-rank test by using Statistical Package for the Social Sciences 11·5 statistical software.

Results

No significant difference regarding the dose distributions and volumes of target, sigmoid and bladder due to leg position was observed, either on 3D planning or on in vivo dose measurements. However, there were significant differences for 25 and 50% isodose coverage of rectum in favour of straight leg position (p=0·026). There were no significant differences regarding maximum doses in any critical organ.

Conclusion

Difference in leg position caused only a small change in rectum dose distribution and did not cause any other change in either dose distributions or in vivo measured doses of both target and critical organs during cervical brachytherapy. Straight leg position appears better with regard to rectum dose.

Keywords

Brachytherapycervical cancerleg position
Type
Original Articles
Information
Journal of Radiotherapy in Practice , Volume 15 , Issue 4 , December 2016 , pp. 341 - 345
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Copyright
© Cambridge University Press 2016 

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