JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
Members of the editorial board are scientists specializing in the field of radiation biology and medicine, radiation protection, radiation epidemiology, radiation oncology, radiation diagnostics and therapy, nuclear medicine and medical physics. The editorial board consists of academicians (members of the Russian Academy of Science (RAS)), the full member of Academy of Medical Sciences of the Republic of Armenia, corresponding members of the RAS, Doctors of Medicine, professor, candidates and doctors of biological, physical mathematics and engineering sciences. The editorial board is constantly replenished by experts who work in the CIS and foreign countries.
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The two-year impact factor of RISC, according to data for 2017, was 0.439, taking into account citation from all sources - 0.570, and the five-year impact factor of RISC - 0.352.
Medical Radiology and Radiation Safety. 2019. Vol. 64. No. 1. P. 45–52
RADIATION THERAPY
DOI: 10.12737/article_5c55fb4a074ee1.27347494
Е.S. Sukhikh1,2, L.G. Sukhikh2, О.Yu. Anikeeva3, P.V. Izhevsky4, I.N. Sheino4
Dosimetric Evaluation for Various Methods of Combined Radiotherapy of Cervical Cancer
1. Tomsk Regional Oncology Center, Tomsk, Russian Federation. E-mail:
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;
2. National Research Tomsk Polytechnic University, Tomsk, Russia;
3. Medical and Rehabilitation Center, Moscow, Russia;
4. A.I. Burnasyan Federal Medical Biophysical Center, Moscow, Russia
Е.S. Sukhikh – Head of Dep., PhD Phys-Math.;
L.G. Sukhikh – Director, PhD Phys.-Math.;
О.U. Anikeeva – Head of Dep., Dr. Sci. Med.;
P.V. Izhevsky – Leading Researcher, PhD Med., Assistant Prof.;
I.N. Sheino – Head of the Lab., PhD Phys.-Math.
Abstract
Purpose: Carrying out dosimetric investigation of possibility to replace a traditional combined radiation therapy of cervical cancer by combinations only external irradiation, without change of total course dose and number of fractions.
Material and methods: Eleven patients with a diagnosis of cervical cancer (stages T2bNхM0 and T3NхM0) who received a course of combined radiotherapy (CRT) have been considered in this study. The combination of dose delivery techniques 3D-CRT + high dose rate brachytherapy (HDR) was used as a basic one. The following fractionation regimes for CRT were simulated: external beam RT (EBRT) of the first stage – total dose 50 Gy and fraction dose 2 Gy (25 fractions), the second stage – total dose 28 Gy and fraction dose 7 Gy (4 fractions). Total CRT course dose was 89.7 Gy EQD2. Dosimetric planning of EBRT using conventional radiography and 3D-CRT has been carried out using XIO dosimetry planning system. Dosimetric planning of first-stage EBRT and second-stage EBRT using the VMAT technique has been performed in the Monaco dosimetry planning system. HDR of the second stage has been planned using the HDRplus dosimetric planning system for the Multisource HDR unit with a 60Co source.
Results: Coverage of the clinical volume of the tumor using HDR, on average, was equal to 95 % of the prescribed dose at 91.8 % of the volume, 110 % of the dose – 75.7 % of the volume. 60Co + VMAT results in the coverage level 95 % of the dose at 97.1 % of the volume and 110 % of the dose at 2.1 % of the volume. 3D-CRT + VMAT provide the coverage level of 95 % of the dose at 98 % of the volume and 110 % of the dose at 2.6 % of the volume. Using the combination VMAT + VMAT allows achieving the average coverage of the target at the level of 98 % of the dose at 97 % of the volume, 110 % of the dose at 8.8 % of the volume. The maximum dose per volume of the organs at risk equal to 2 cm3 did not exceed their tolerant levels both for the bladder and for the rectum.
Conclusion: At present, there is a technical possibility to replace the second stage of CRT cervical cancer by EBRT using the VMAT technique. Implementation of the VMAT technique allows to increase the uniformity of irradiated volume coverage comparing with traditional HDR. While using VMAT technique the tolerant levels of organs at risk are not exceeded.
Key words: combined radiotherapy, brachytherapy, external beam radiation therapy, cervical cancer, dosimetric evaluation
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For citation: Sukhikh ЕS, Sukhikh LG, Anikeeva ОYu, Izhevsky PV, Sheino IN. Dosimetric Evaluation for Various Methods of Combined Radiotherapy of Cervical Cancer. Medical Radiology and Radiation Safety. 2019;64(1):45-52. (Russian).
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