eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
SCImago Journal & Country Rank

6/2022
vol. 14
 
Share:
Share:
more
 
 
abstract:
Original paper

Comparison of vaginal gauze packing technique with or without balloon in high-dose-rate brachytherapy of uterine cervical cancer: a crossover randomized controlled trial

Rishanthini Dhanapalan
1
,
Jagadesan Pandjatcharam
1
,
K. Saravanan
2
,
Ninad Harish Patil
1

1.
Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
2.
Medical Physics, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
J Contemp Brachytherapy 2022; 14, 6: 551–559
Online publish date: 2022/12/30
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Purpose
To compare the rectal and bladder doses using two different vaginal packing techniques among uterine cervical cancer patients receiving high-dose-rate (HDR) intracavitary brachytherapy (ICBT).

Material and methods
Forty-five patients with cervical cancer were randomized to receive two sessions of ICBT using tandem and ring applicator (Varian©), following completion of pelvic external beam radiotherapy treatment. The procedure was performed with vaginal balloon plus gauze packing or vaginal gauze packing alone, each of which was used in one of two sessions. Sequence of the type of vaginal packing was chosen with computer-generated block randomization. A HDR dose of 8.5 Gy was prescribed to point A in all patients. Volumetric dose parameters, such as D0.1cc, D0.5cc, D1cc, and D2cc of the rectum and bladder were compared between the two techniques of vaginal packing.

Results
The mean age of patients was 51 years. Majority (88%) of patients had locally advanced stages of cancer at baseline (stage IIB or more). Rectal doses were significantly less in combined packing technique (D0.1cc: 7.52 Gy vs. 9.02 Gy, p = 0.01; D0.5cc: 6.46 Gy vs. 7.42 Gy, p < 0.01; D1cc: 5.91 Gy vs. 6.7 Gy, p < 0.01; D2cc: 5.29 Gy vs. 5.97 Gy, p < 0.01). Bladder doses were higher in the combined packing technique (D0.1cc: 11.20 Gy vs. 10.76 Gy, p = 0.18; D0.5cc: 9.64 Gy vs. 9.32 Gy, p = 0.56; D1cc: 8.64 Gy vs. 8.36 Gy, p = 0.55; D2cc: 7.56 vs. 7.33 Gy, p = 0.55).

Conclusions
Combined vaginal packing resulted in statistically significant reduction in rectal radiation dose compared with standard vaginal gauze packing in high-dose-rate brachytherapy of cervix cancer using tandem and ring applicators.

keywords:

cervical cancer, brachytherapy, vaginal packing, high-dose-rate brachytherapy, rectal dosimetry, intra-vaginal balloon, tandem and ring applicator

 
Quick links
© 2023 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.