跳至主要内容

An Innovative Concept of High-Dose-Rate (HDR) Intracavitary Brachytherapy with an Intrauterine Inflatable Balloon for Endometrial Carcinoma

Read full paper at:
http://www.scirp.org/journal/PaperInformation.aspx?PaperID=49184#.VJJw0snQrzF

Purpose: Curative radiation therapy is an established treatment option for non-surgical patients with early-stage endometrial carcinoma. Dosimetric analyses were performed using a single tandem, double tandem, Heyman capsules, and an inflatable intrauterine balloon to assess the dose homogeneity and conformality in the definitive treatment of inoperable endometrial cancer. Methods and Materials: Patients’ informed-consent was obtained. Dosimetric analyses were performed using four different after-loading applicators to assess the dose homogeneity and conformality of isodose to the three-dimensional (3-D) shape of the target volume (uterus) based on CT data in four patients (n = 4). The single tandem and double tandems were standard Fletcher-type (Nucletron Corporation, Columbia, MD). Heyman capsules were the disposable after-loading type (Radiation Products Design, Inc., Albertville, MN). The inflatable balloon with a central bi-lumen catheter was the Mammo Site Radiation Therapy System (Proxima Therapeutics, Alpharetta, GA) that is currently used for local breast brachytherapy. Treatment planning and dosimetric analyses for all four techniques were done with HDR PLATO Brachytherapy (v14.2.3) Software (Nucletron Corporation). Results: The average dose gradient within the target (uterine wall) is highest with the tandem methods, followed by Heyman capsules. The intrauterine balloon method showed the least dose gradient across the uterine wall. The corresponding average homogeneity indices were 3.81, 3.83, 2.97, 2.50 for single tandem, double tandem, Heyman capsules, and intrauterine balloon respectively. Conclusions: The intra-uterine inflatable balloon appears to have the best overall dosimetric advantages for the treatment of the uterine wall. Furthermore, the potential ease of use, shorter time of applicator placement, and better patient comfort warrant further investigation and subsequent clinical implementation.
Cite this paper
Patel, A. , Cummins, S. , Luh, J. and Eng, T. (2014) An Innovative Concept of High-Dose-Rate (HDR) Intracavitary Brachytherapy with an Intrauterine Inflatable Balloon for Endometrial Carcinoma. Journal of Cancer Therapy, 5, 878-883. doi: 10.4236/jct.2014.59095. 
 

[1] American Cancer Society (2013) Endometrial (Uterine) Cancer.
http://www.cancer.org/Cancer/EndometrialCancer/DetailedGuide/endometrial-uterine-cancer-key-statistics
[2] Nguyen, T.V. and Petereit, D.G. (1998) High-Dose-Rate Brachytherapy for Medically Inoperable Stage I Endometrial Cancer. Gynecologic Oncology, 71, 196-203. http://dx.doi.org/10.1006/gyno.1998.5148
[3] Fishman, D.A., Roberts, K.B., Chambers, J.T., et al. (1996) Radiation Therapy as Exclusive Treatment for Medically Inoperable Patients with Stage I and II Endometrioid Carcinoma with Endometrium. Gynecologic Oncology, 61, 189-196. http://dx.doi.org/10.1006/gyno.1996.0123
[4] Rouanet, P., Dubois, J.B., Gely, S., et al. (1993) Exclusive Radiation Therapy in Endometrial Carcinoma. International Journal of Radiation Oncology*Biology*Physics, 26, 223-228.
[5] Lehoczky, O., Bosze, P., Ungar, L., et al. (1991) Stage I Endometrial Carcinoma: Treatment of Nonoperable Patients with Intracavitary Radiation Therapy Alone. Gynecologic Oncology, 43, 211-216. http://dx.doi.org/10.1016/0090-8258(91)90022-W
[6] Kucera, H., Knocke, T.H., Kucera, E., et al. (1998) Treatment of Endometrial Carcinoma with High-Dose-Rate Brachytherapy Alone in Medially Inoperable Stage I Patients. Acta Obstetricia et Gynecologica Scandinavica, 77, 1008-1012. http://dx.doi.org/10.1080/j.1600-0412.1998.771011.x
[7] Knocke, T.H., Kucera, H., Weidinger, B., et al. (1997) Primary Treatment of Endometrial Carcinoma with Highdose-Rate Brachytherapy: Results of 12 Years of Experience with 289 Patients. International Journal of Radiation Oncology*Biology*Physics, 37, 359-365.
[8] Kupelian, P.A., Eifel, P. and Tornos, C. (1993) Treatment of Endometrial Carcinoma with Radiation Therapy Alone. International Journal of Radiation Oncology*Biology*Physics, 27, 817-824.
[9] Grisby, P.W., Kuske, R.R., Perez, C.A., et al. (1987) Medically Inoperable Stage I Adenocarcinoma of the Endometrium Treated with Radiotherapy Alone. International Journal of Radiation Oncology*Biology*Physics, 13, 483-488.
[10] Niazi, T.M., Souhami, L., Portelance, L., et al. (2005) Long-Term Results of High-Dose-Rate Brachytherapy in the Primary Treatment of Medically Inoperable Stage I-II Endometrial Carcinoma. International Journal of Radiation Oncology*Biology*Physics, 63, 1108-1113.
[11] Coon, D., Beriwal, S., Heron, D.E., et al. (2008) High-Dose-Rate Rotte “Y” Applicator Brachytherapy for Definitive Treatment of Medically Inoperable Endometrial Cancer: 10-Year Results. International Journal of Radiation Oncology*Biology*Physics, 71, 799-783.
[12] Potter, R., Gerbaulet, A. and Haie-Meder, C. (2002) The GEC-ESTRO Handbook of Brachytherapy. Endometrial Cancer. http://estro-education.org/publications/Documents/IB%2015%2029072002%20 Endometrial%20Cancer%20print_procTW.pdf
[13] Nag, S., Erickson, B., Parikh, S., et al. (2000) The American Brachytherapy Society Recommendations for High-Dose-Rate Brachytherapy for Carcinoma of the Endometrium. International Journal of Radiation Oncology*Biology*Physics, 48, 779-790.
[14] Vicini, F., Beitsch, P., Quiet, C., et al. (2011) Five-Year Analysis of Treatment Efficacy and Cosmesis by the American Society of Breast Surgeons Mammo Site Breast Brachytherapy Registry Trial in Patients Treated with Accelerated Partial Breast Irradiation. International Journal of Radiation Oncology*Biology*Physics, 79, 808-817.
[15] Miller, D.A., Richardson, S. and Grigsby, P.W. (2010) A New Method of Anatomically Conformal Vaginal Cuff HDR Brachytherapy. Gynecologic Oncology, 116, 413-418.
http://dx.doi.org/10.1016/j.ygyno.2009.10.044                eww141218lx
标签：

评论

发表评论

此博客中的热门博文

Does Immigration Promote the Investment of the Monopolistic Firm?

In the present paper, we examine the effect of increasing uncertainty of immigrants’ growth on the optimal timing of investment of a firm that has a monopolistic power over the labor market. It is revealed that when the uncertainty of immigrants’ growth is more than a threshold level, increasing uncertainty of immigrants’ growth accelerates the optimal timing of firms’ investment and enhances the economic growth, even if the uncertainty of immigrants’ growth is formulated by the geometric Brownian motion, which is in sharp contrast to the standard result that an increase in the uncertainty postpones the optimal timing. With an increase in the immigrants over the past ten years, workforces in the host countries have been growing significantly to the extent that the immigrants represent 70% of the increase in the workforce in Europe, and 47% in the United States as OECD indicates. In the present paper, we attempted to investigate the effect of increased uncertainty caused by the growi...
发表评论
阅读全文

Education Policy Implementation: A Mechanism for Enhancing Primary Education Development in Zanzibar

Education is one of the fundamental rights of individuals; therefore, the government of a country needs to develop and strengthen educational policy and quality as well as to ensure that everyone has equal access to basic education. The improvement of access and quality of education in the world is becoming as an essential factor in development, whereas the basic education (primary school), is acknowledged as a foundation of the higher educational development for every country. To fulfill this goal, governments introduce several policies and procedures; however, it requires some reforms and participation from the politician, policymakers, and other stakeholders to re-examine educational policy so that it can lead to multiplication and betterment of the reforms. Educational reforms actually focus on accountability. A positive educational development and reform is very challenging and needs more effort and strategy on how to use and utilize the resources effectively as such it can achie...
发表评论
阅读全文