METHODOLOGY OF 3D GRAPHIC BRACHYTHERAPY FOR CERVICAL CANCER
Relevance. Effective treatment of cervical cancer is one of the most important medical and social tasks of modern gynecological oncology. Despite the fact that a large number of different modes of brachytherapy are currently known and used in practice, the choice of the optimal mode is still a matter of debate. The fractionation regimen and the choice of total doses are decisive factors in reducing the incidence of complications with radiation therapy and do not worsen the results of treatment.
Aim: description of the 3D planning method for brachytherapy in the radiotherapy program for locally advanced cervical cancer.
Materials and research methods. The first stage was remote radiation therapy (2.0 Gy, 5 fractions per week, total radiation dose (TRD) was 50 Gy).In parallel the chemotherapy (Cisplatin, 40 mg / m2) was carried out. Starting from the 5th week, when the TRD was at least 40 Gy, 3D brachytherapy sessions were started (4 sessions of 6.0-7.0 Gy per week), while the TD of combined RT was 74.0-78.0 Gr. During choosing the volume and distribution of radiation doses, the recommendations of the International Commission - ICRU were applied. The treatment was carried out on a GammaMedPlus apparatus with a 192 Ir source in a high dose rate (HDR) mode. The plans were calculated using the Varian radiotherapy complex with the ECLIPSE planning system. The assessment of the quality of the exposure plan was carried out on the basis of monitoring the dose-volume histograms.
Research results. the study is methodological in nature and includes a detailed description of the conduct of 3D brachytherapy in the radiotherapy program for locally advanced cervical cancer.
Conclusion. Optimization of radiation therapy using 3D brachytherapy creates clinically favorable conditions for effective therapy: it reduces the risk of displacement of the applicators, reduces the load by reducing the total radiation doses, the frequency of severe early and late toxic effects, providing good local control indicators regardless of tumor size and clinical stage. The choice of rational fractionation schemes and the methodology for accounting for the dose load made it possible to optimize the irradiation programs taking into account the individual parameters of the tumor process, the spatial relationship of the tumor and risk organs, as well as the constitutional characteristics of the patient, thereby ensuring a higher level of quality of life.
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Kaidarova D.R., Andreyeva O.B., Adylkhanov T.A., Kurmangaliyev T.S., Kamzina G.S., Bokembayeva A.A. Methodology of 3D graphic brachytherapy for cervical cancer // Nauka i Zdravookhranenie [Science & Healthcare]. 2020, (Vol.22) 6, pp. 63-70. doi 10.34689/SH.2020.22.6.009Related publications:
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