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Brachytherapy Planning and Evaluation

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Basics of Planning and Management of Patients during Radiation Therapy

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Abstract

The development of 3D image-based treatment planning in brachytherapy has significantly improved the 3D assessment of dose-volume relations. Dose distribution can now be evaluated in different volumes such as the GTV, CTV, PTV and most relevant organs at risk (OARs). In general, in brachytherapy, target and organs at risk (OARs) volumes are similar to that in external beam radiotherapy, while prescriptions are based on International Commission on Radiation Units and Measurements (ICRU) Reports 38 and 58. The gross tumour volume (GTV) is the gross palpable or visible/demonstrable extent and location of the malignant growth. The GTV may appear to be different in size and shape, depending on the examination technique used for evaluation, and therefore, the radiation oncologist should, in each case, indicate which method has been used for delineation of the GTV. The definitions of GTV and CTV in brachytherapy are identical to the definitions given for external beam radiotherapy in ICRU Reports 50 and 62. The CTV (according to GEC-ESTRO) is also divided based on clinical examination and MRI study into high-risk CTV (HR CTV) which is at major risk of recurrence and intermediate-risk CTV (IR CTV) which has risk of recurrence in areas that initially had macroscopic extent of disease with residual microscopic disease at time of BT. During evaluation of plans, V90%, V150% and V200%, i.e. volumes of PTV receiving 90%, 150% and 200% of prescribed dose, respectively, are a clinically more relevant parameter. V200% in the target volume should ideally be located inside the applicator and V150% as far as possible at the tissue-applicator interface. The PTV should be covered by 85–90% isodose but not less than 80% isodose.

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Authors and Affiliations

  1. Department of Radiotherapy, Regional Cancer Centre, JIPMER Department of Radiotherapy, Puducherry, India

    Ashutosh Mukherji

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  1. Ashutosh Mukherji
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Mukherji, A. (2018). Brachytherapy Planning and Evaluation. In: Basics of Planning and Management of Patients during Radiation Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-10-6659-7_14

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  • DOI: https://doi.org/10.1007/978-981-10-6659-7_14

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6658-0

  • Online ISBN: 978-981-10-6659-7

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