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Variation of optimization techniques for high dose rate brachytherapy in cervical cancer treatment
Ahmad Naqiuddin Azahari,Ahmad Tirmizi Ghani,Reduan Abdullah,Jayapramila Jayamani,Gokula Kumar Appalanaido,Jasmin Jalil,Mohd Zahri Abdul Aziz 한국원자력학회 2022 Nuclear Engineering and Technology Vol.54 No.4
High dose rate (HDR) brachytherapy treatment planning usually involves optimization methods todeliver uniform dose to the target volume and minimize dose to the healthy tissues. Four optimizationswere used to evaluate the high-risk clinical target volume (HRCTV) coverage and organ at risk (OAR). Dose-volume histogram (DVH) and dosimetric parameters were analyzed and evaluated. Better coveragewas achieved with PGO (mean CI ¼ 0.95), but there were no significant mean CI differences than GrO(p ¼ 0.03322). Mean EQD2 doses to HRCTV (D90) were also superior for PGO with no significant meanEQD2 doses than GrO (p ¼ 0.9410). The mean EQD2 doses to bladder, rectum, and sigmoid weresignificantly higher for NO plan than PO, GrO, and PGO. PO significantly reduced the mean EQD2 doses tobladder, rectum, and sigmoid but compromising the conformity index to HRCTV. PGO was superior inconformity index (CI) and mean EQD2 doses to HRCTV compared with the GrO plan but not statisticallysignificant. The mean EQD2 doses to the rectum by PGO plan slightly exceeded the limit from ABSrecommendation (mean EQD2 dose ¼ 78.08 Gy EQD2). However, PGO can shorten the treatment planningprocess without compromising the CI and keeping the OARs dose below the tolerance limit.