Dosimetric divergence in ICBT vs. IC/ISBT configurations: Comparative analysis of three optimization algorithms for cervical cancer brachytherapy
Year: 2025
Type: article
Abstract: OBJECTIVE: To compare dosimetric differences among graphical-based manual planning (MA), simulated annealing inverse optimization (IPSA), and hybrid inverse optimization (HIPO) for cervical cancer in both intra-cavitary brachytherapy (ICBT) and interstitial brachytherapy combined with ICBT (IC/ISBT) settings, providing evidence for clinical optimization method selection. METHODS: This study consisted of 60 cervical cancer patients undergoing CT-guided three-dimensional brachytherapy, including 30 ICBT patients and 30 IC/ISBT patients. Plans were generated using MA, IPSA, and HIPO. The dosimetric parameters for the high-risk clinical target volume (HRCTV) including D100%, V150%, V200%, conformity index (CI), homogeneity index (HI) were compared. Meanwhile, the dosimetric parameters D1cc, D2cc for the bladder, rectum, sigmoid, and total treatment time were evaluated. RESULTS: Compared with MA, both IPSA and HIPO delivered lower doses to organs at risk (OARs). The total treatment time was significantly shorter for HIPO compared to IPSA and MA (P < 0.05). In ICBT patients, the D1cc and D2cc of OARs were lower for IPSA compared to HIPO (P > 0.05), while the CI was significantly better for HIPO (P < 0.05). Nevertheless, in IC/ISBT patients, D2cc of rectum for HIPO was significantly lower compared to IPSA (P < 0.05), with better CI. CONCLUSION: Inverse optimization effectively reduces doses to OARs while maintaining target coverage. HIPO appears to be the preferred choice for IC/ISBT, due to shortened treatment time, superior CI and rectal protection compared with IPSA.
Source: PLoS ONE
Language: English
Subfield: Radiation
Field: Physics and Astronomy
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $2,382
Funder: Fujian Medical University
OpenAlex ID: W4416178346