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Gaceta Médica Boliviana
Print version ISSN 1012-2966On-line version ISSN 2227-3662
Abstract
LEON-RAMOS, Lila G.; GUZMAN-CALCINA, Carmen S. and QUENHUA-HUAPULA, Rubén A.. Evaluation of "A" points as a dosimetric parameter in gynecological brachytherapy guided by threedimensional images. Gac Med Bol [online]. 2023, vol.46, n.2, pp.87-92. Epub Dec 01, 2023. ISSN 1012-2966. https://doi.org/10.47993/gmb.v46i2.667.
Objective:
to assess whether the punctual dose prescription technique, point A, is adequate for dose estimation in CTV-HR using 3D gynecological brachytherapy.
Methods:
treatment plans were collected for 35 patients with stage IB2-IVA (140 fractions or treatment plans) cervical cancer treated between 2019 and 2021, whose prescribed dose was 28Gy in 4 fractions. Points A were reconstructed, the prescribed dose was normalized to 100% isodose to compare with the doses in CTV- HR(D90%).
Results:
the average dose absorbed at CTV-HR(D90%) was 88.82 ±2.53 Gy and when normalizing the isodose of 100% at point A, average dose at CTV-HR(D90%) was obtained. of 99.3±5.85Gy. This average dose variation to the CTV-HR(D90%) represented an increase of 18%, resulting in 80% of the treatments corresponding to 28 patients falling outside the acceptable variation of the EMBRACE II protocol and only 20% of the treatments corresponding to 7 patients are within the range of the acceptable variation of the protocol in question.
Conclusions:
the dose prescription technique at point A clinically translates into an overdose of tumor and healthy tissue (rectum, sigmoid, bladder and intestine).
Keywords : brachytherapy; cervical cancer; radiation absorption; radiation dose.