Dosimetric Evaluation of a Flexible Dual Balloon-Constructed Applicator in Treating Anorectal Cancer

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Abstract

Background and Purpose: To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions. Materials and Methods: Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume, the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum. Results: Increasing inner balloon volume directly increased both the space between the active source channels and the radial distance of the active source channel to the inner surface of the global target volume. The space between the active source channels and the percentage of global target volume received 150% or more of the prescribed dose to target had a strong inverse correlation (−0.881/P =.007, −0.976/P =.001, respectively) with the radial distance of the active source channel to the inner surface of the global target volume. Conformity index, dose to 2 cm3 of rectum, and total reference air kerma were strongly correlated with the radial distance of the active source channel to the inner surface of the global target volume, with values of 0.952 (P =.001), 0.833 (P =.015), and 0.922 (P =.002), respectively. Percentage of global target volume received 150% or more of the prescribed dose was significantly correlated with the space between the active source channels (0.81/P =.022), and conformity index was strongly inversely correlated with the space between the active source channels (−0.833/P =.015). Conclusion: The dual balloon-constructed Anorectal Applicator offers a flexible way to adjust the distances of the active source positions to the target in relation to uninvolved rectal wall. This flexibility simplifies planning which results in a highly conformal dose distribution to the target lesion while minimizing dose to normal rectal tissue.

Original languageEnglish (US)
Pages (from-to)879-884
Number of pages6
JournalTechnology in Cancer Research and Treatment
Volume16
Issue number6
DOIs
StatePublished - Dec 1 2017

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Rectum
Brachytherapy
Neoplasms
Catheters
Air
Water
Therapeutics

Keywords

  • brachytherapy
  • dual balloon
  • rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{8604ff73594a460f8fc15eaafef9dba3,
title = "Dosimetric Evaluation of a Flexible Dual Balloon-Constructed Applicator in Treating Anorectal Cancer",
abstract = "Background and Purpose: To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions. Materials and Methods: Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume, the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum. Results: Increasing inner balloon volume directly increased both the space between the active source channels and the radial distance of the active source channel to the inner surface of the global target volume. The space between the active source channels and the percentage of global target volume received 150{\%} or more of the prescribed dose to target had a strong inverse correlation (−0.881/P =.007, −0.976/P =.001, respectively) with the radial distance of the active source channel to the inner surface of the global target volume. Conformity index, dose to 2 cm3 of rectum, and total reference air kerma were strongly correlated with the radial distance of the active source channel to the inner surface of the global target volume, with values of 0.952 (P =.001), 0.833 (P =.015), and 0.922 (P =.002), respectively. Percentage of global target volume received 150{\%} or more of the prescribed dose was significantly correlated with the space between the active source channels (0.81/P =.022), and conformity index was strongly inversely correlated with the space between the active source channels (−0.833/P =.015). Conclusion: The dual balloon-constructed Anorectal Applicator offers a flexible way to adjust the distances of the active source positions to the target in relation to uninvolved rectal wall. This flexibility simplifies planning which results in a highly conformal dose distribution to the target lesion while minimizing dose to normal rectal tissue.",
keywords = "brachytherapy, dual balloon, rectal cancer",
author = "Hsiang-Chi Kuo and Mehta, {Keyur J.} and Ravindra Yaparpalvi and Alan Lee and Dinesh Mynampati and Bodner, {William R.} and Garg, {Madhur K.} and David Huang and Tome, {Wolfgang A.} and Shalom Kalnicki",
year = "2017",
month = "12",
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doi = "10.1177/1533034617707433",
language = "English (US)",
volume = "16",
pages = "879--884",
journal = "Technology in Cancer Research and Treatment",
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T1 - Dosimetric Evaluation of a Flexible Dual Balloon-Constructed Applicator in Treating Anorectal Cancer

AU - Kuo, Hsiang-Chi

AU - Mehta, Keyur J.

AU - Yaparpalvi, Ravindra

AU - Lee, Alan

AU - Mynampati, Dinesh

AU - Bodner, William R.

AU - Garg, Madhur K.

AU - Huang, David

AU - Tome, Wolfgang A.

AU - Kalnicki, Shalom

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Background and Purpose: To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions. Materials and Methods: Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume, the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum. Results: Increasing inner balloon volume directly increased both the space between the active source channels and the radial distance of the active source channel to the inner surface of the global target volume. The space between the active source channels and the percentage of global target volume received 150% or more of the prescribed dose to target had a strong inverse correlation (−0.881/P =.007, −0.976/P =.001, respectively) with the radial distance of the active source channel to the inner surface of the global target volume. Conformity index, dose to 2 cm3 of rectum, and total reference air kerma were strongly correlated with the radial distance of the active source channel to the inner surface of the global target volume, with values of 0.952 (P =.001), 0.833 (P =.015), and 0.922 (P =.002), respectively. Percentage of global target volume received 150% or more of the prescribed dose was significantly correlated with the space between the active source channels (0.81/P =.022), and conformity index was strongly inversely correlated with the space between the active source channels (−0.833/P =.015). Conclusion: The dual balloon-constructed Anorectal Applicator offers a flexible way to adjust the distances of the active source positions to the target in relation to uninvolved rectal wall. This flexibility simplifies planning which results in a highly conformal dose distribution to the target lesion while minimizing dose to normal rectal tissue.

AB - Background and Purpose: To assess the dosimetric flexibility of a dual balloon brachytherapy applicator developed for the treatment of anorectal lesions. Materials and Methods: Different amounts of water were infused into the inner and outer balloon separately to study the asymmetrical distribution of the catheter, the radial distance of the active source channel to the inner surface of the global target volume, the space between the active source channels, and their dosimetric impact to target tissues and uninvolved rectum. Results: Increasing inner balloon volume directly increased both the space between the active source channels and the radial distance of the active source channel to the inner surface of the global target volume. The space between the active source channels and the percentage of global target volume received 150% or more of the prescribed dose to target had a strong inverse correlation (−0.881/P =.007, −0.976/P =.001, respectively) with the radial distance of the active source channel to the inner surface of the global target volume. Conformity index, dose to 2 cm3 of rectum, and total reference air kerma were strongly correlated with the radial distance of the active source channel to the inner surface of the global target volume, with values of 0.952 (P =.001), 0.833 (P =.015), and 0.922 (P =.002), respectively. Percentage of global target volume received 150% or more of the prescribed dose was significantly correlated with the space between the active source channels (0.81/P =.022), and conformity index was strongly inversely correlated with the space between the active source channels (−0.833/P =.015). Conclusion: The dual balloon-constructed Anorectal Applicator offers a flexible way to adjust the distances of the active source positions to the target in relation to uninvolved rectal wall. This flexibility simplifies planning which results in a highly conformal dose distribution to the target lesion while minimizing dose to normal rectal tissue.

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