The Associations for Vaginal Point Doses of Vaginal Stenosis in Image-Guided Brachytherapy

Ekkasit Tharavichitkul, Rungtip Jayavasti, Razvan M. Galalae, Damrongsak Tippanya, Sukon Prasitwattanaseree, Wannapa Nobnop, Somvilai Chakrabandhu, Pitchayaponne Klunklin, Wimrak Onchan, Somsak Wanwilairat, Imjai Chitapanarux

Faculty of Medicine, Christian-Albretch University, Kiel, Germany.
Science and Technology Research Institute, Chiang Mai University, Chiang Mai, Thailand.
The Division of Therapeutic Radiology and Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

DOI: 10.4236/jct.2014.59090                

Abstract

Purpose: To evaluate the associations for vaginal dose points of vaginal stricture in image-guided brachytherapy. Materials and Methods: Twenty-six patients of locally advanced cervical cancer were treated with Image-Guided Brachytherapy (IGBT) with the dose at least 7 Gy per fraction to the D90 of High-Risk Clinical Target Volume (HR-CTV). The vaginal dose points of recommendations of the American Brachytherapy Society (ABS) were added into the plan and cumulative dose to these points was evaluated in Equivalent Dose of 2 Gy (EQD2) concepts. Results: The mean doses to right vaginal dose point (VR), left vaginal dose point (VL) and average dose of VR/VL ((VR + VL)/2) were 101.5 Gy, 98.2 Gy and 99.8 Gy in EQD2 concepts, respectively. Volume-based planning significantly reduced the cumulative dose in EQD2 concepts at vaginal points. At the median follow-up time of 22 months, grade-2 vaginal stricture was observed in two patients. The incidences of vaginal stricture were not differed between the cumulative dose to vaginal dose points in EQD2 concepts of ≤90 Gy versus >90 Gy (P = 1.000) and ≤100 Gy versus >100 Gy (P = 0.815). Conclusion: No association for cumulative vaginal doses and events of vaginal stricture was found.

Keywords

Image-Guided Brachytherapy, Vaginal Dose Point, Vaginal Stricture, Associations

Conflicts of Interest

The authors declare no conflicts of interest.

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