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Program Information

Feasibility of Newly Designed Applicator for High Dose Rate Brachytherapy Treatment of Patients with Vaginal Vault Recurrence

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V Lee

V Lee1*, X Huang2 , M Wong1 , M Chan1 , E Chui2 , S Cheung1 , R Leung1 , K Lee1 , G Law1 , K Leung2 , S Tung1 , D Kwong3 , (1) Tuen Mun Hospital, Hong Kong (2) The Chinese University of Hong Kong, Hong Kong (3) The University of Hong Kong, Hong Kong

Presentations

SU-G-TeP2-10 (Sunday, July 31, 2016) 4:30 PM - 5:00 PM Room: ePoster Theater


Purpose:
To compare the dose of an in-house 3D-printed gynecology applicator (TMHGA) for vaginal vault recurrence of corpus cancer patients after operation for high dose rate brachytherapy treatment with commercially available applicators.

Methods:
A newly designed applicator is made from 3D-printing methods using ABSM30i. The isodose of the applicator is compared with Elekta multi-channel (MC) applicator and titanium Rotterdam applicator with coupling central tube and vaginal cylinder (RC). Three plans are created using three applicators in a CT set of water phantom. The applicators are anchored using the applicator library and implant library in the Elekta Oncentra treatment planning system (ver.4.5). The rectum is mimicked by creating a 2cm diameter cylinder, with a distance 1mm posteriorly away from the high risk CTV (HR-CTV). Similarly, the bladder is replicated by a 6cm diameter cylinder with distance 1mm anteriorly from the HR-CTV. Three plans are all normalized 1.5cm superior, 0.5cm anterior and 0.5cm posterior of the applicator surface. By fixing D90 of HR-CTV to 6Gy, the D2cc of rectum and bladder of three plans are compared.

Results:
The D2cc of the bladder for using TMHGA is lower than MC and RC by 14.0% and 11.9% respectively. While the D2cc of the rectum for using TMHGA is lower than MC and RC by 18.9% and 12.4% respectively. The total treatment time of TMHGA plan is shorter than MC and RC by 11.2% and 12.9%.

Conclusion:
The applicator created via 3D printing delivers a lower dose to the bladder and the rectum while keeping the same coverage to HR-CTV as other commercially available applicators. Additionally, the new applicator resulted in a reduction of treatment time, which is always welcome.


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