Impact of changes in body contours on radiation therapy dose distribution after uterine cervical cancer surgery

Jpn J Radiol. 2020 Nov;38(11):1099-1107. doi: 10.1007/s11604-020-01011-6. Epub 2020 Jul 2.

Abstract

Purpose: Patients receiving postoperative irradiation for uterine cervical cancer might not be able to eat during radiation therapy because of the effects of concurrent chemo-radiotherapy; this may lead to changes in the patient's body shape during treatment. When performing image-guided radiotherapy, it is necessary to determine immediately whether treatment can be performed on the day or whether re-planning is required. The purpose of this study was to determine indicators for re-planning by examining the effects of changing body contours on radiation therapy dose.

Materials and methods: The original body contour was reduced by 1 cm in the front portion (structure-set 1). Based on the original dose distribution, the dose recalculation was performed with a structure set created using the body contour of structure-set 1. The difference between the original and recalculated dose distributions of structure-set 1 was evaluated through gamma analysis (GA).

Result: In the GA results for dose distribution obtained via recalculation with structure-set 1, a pass rate of 90% or more was obtained for a criterion of 2 mm/2% in all cases.

Conclusions: The results suggest that dose re-planning is rarely required when the body shape is reduced by only 1 cm in the front.

Keywords: After uterine cervical cancer surgery; Body shape change; VMAT.

MeSH terms

  • Body Constitution* / immunology
  • Cervix Uteri / diagnostic imaging
  • Cervix Uteri / surgery
  • Cone-Beam Computed Tomography / methods
  • Female
  • Humans
  • Postoperative Care / methods*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Image-Guided / methods*
  • Radiotherapy, Intensity-Modulated / methods*
  • Tomography, X-Ray Computed / methods*
  • Uterine Cervical Neoplasms / radiotherapy*
  • Uterine Cervical Neoplasms / surgery