BLADDER AND RECTAL DOSES USING TWO DIFFERENT INTRACAVITARY BRACHYTHERAPY APPLICATOR SYSTEMS IN CERVICAL CANCER – A RETROSPECTIVE ANALYSIS

Dr. Praloy Basu; Dr. Arnab Adhikary; Dr. Debabrata Mitra

Volume : VIII, Issue : V, May - 2019

BLADDER AND RECTAL DOSES USING TWO DIFFERENT INTRACAVITARY BRACHYTHERAPY APPLICATOR SYSTEMS IN CERVICAL CANCER – A RETROSPECTIVE ANALYSIS

Dr. Praloy Basu, Dr. Arnab Adhikary, Dr. Debabrata Mitra

Abstract :

INTRODUCTION : In achytherapy, the dose delivered to the tissues is mainly determined by the inverse square law and not by attenuation caused by intervening tissues. Applicator geometry may play an important role in such dose distribution. The study aimed to retrospectively analyze the effect of applicator geometry i.e. the choice of Manchester style or Fletcher–Suit applicators on the dose to the organs at risk (OARs) during Intracavitary Brachytherapy for Cervical Cancer. MATERIALS AND METHODS : A single institutional retrospective study was carried out by evaluating the Dose Volume Histogram (DVH) data of 161 patients of Carcinoma Cervix Stage IB–IVA who received Intracavitary Brachytherapy (ICBT) between January 2016 and December 2017. All patients were treated with EBRT 50Gy in 25 fractions (+/– Concurrent Cisplatin 50mg/m2 weekly) followed by ICBT of 7Gy x 3 fractions using either Manchester style or Fletcher Suit applicators. D2cc, D1cc and D0.1cc were recorded for the OARs i.e. Urinary Bladder and Rectum and analyzed using IBM SPSS v23 by applying the Unpaired T–test. RESULTS : Mean age of the study population was 50.89 years. 41.61% of patients presented with Stage IIB Carcinoma Cervix. Manchester style applicator was used in 91 patients while Fletcher Suit applicator was used in 70 patients. D2cc, D1cc and D0.1cc for Bladder were significantly higher in case of Manchester style applicator. No statistically significant difference was seen in case of the rectal dose parameters. CONCLUSION : Fletcher Suit applicator by providing a better OAR dose distribution may improve therapeutic ratio in ICBT for Carcinoma Cervix