The purpose of this study was to investigate the concurrent effects of tandem length and bladder volume on dose to pelvic organs at risk (OARs) in HDR intracavitary brachytherapy treatment of cervical cancer. Twenty patients with locally advanced cervical cancer were selected for brachytherapy using Rotterdam applicators. The patients were CT scanned twice with empty and full bladder. Two treat...

PURPOSE Setup, range, and anatomical uncertainties influence the dose delivered with intensity modulated proton therapy (IMPT), but clinical quantification of these errors for oropharyngeal cancer is lacking. We quantified these factors and investigated treatment fidelity, that is, robustness, as influenced by adaptive planning and by applying more beam directions. METHODS AND MATERIALS We us...

PURPOSE To eliminate or reduce the error to Pareto optimality that arises in Pareto surface navigation when the Pareto surface is approximated by a small number of plans. METHODS The authors propose to project the navigated plan onto the Pareto surface as a postprocessing step to the navigation. The projection attempts to find a Pareto optimal plan that is at least as good as or better than t...

Radiotherapy treatment plan may be replanned due the changes of tumors and organs at risk (OARs) during the treatment. Deformable image registration (DIR) based Computed Tomography (CT) contour propagation in the routine clinical setting is expected to reduce time needed for necessary manual tumors and OARs delineations and increase the efficiency of replanning. In this study, a DIR method was ...

This work aimed at evaluating the performance of three different intensity-modulated radiotherapy (IMRT) treatment planning systems (TPSs)--KonRad, XiO and Prowess--for selected pediatric cases. For this study, 11 pediatric patients with different types of brain, orbit, head and neck cancer were selected. Clinical step-and-shoot IMRT treatment plans were designed for delivery on a Siemens ONCOR...

PURPOSE To describe a multiplan intensity-modulated radiotherapy (IMRT) planning framework, and to describe a decision support system (DSS) for ranking multiple plans and modeling the planning surface. METHODS AND MATERIALS One hundred twenty-five plans were generated sequentially for a head-and-neck case and a pelvic case by varying the dose-volume constraints on each of the organs at risk (...

Non-coplanar radiation beams are often used in three-dimensional conformal and intensity modulated radiotherapy to reduce dose to organs at risk (OAR) by geometric avoidance. In volumetric modulated arc radiotherapy (VMAT) non-coplanar geometries are generally achieved by applying patient couch rotations to single or multiple full or partial arcs. This paper presents a trajectory optimization m...

Three dimensional (3D) imaging is key to the successful planning and delivery of pelvic radiotherapy treatment and is integrated into every step of the radiotherapy treatment pathway. Diagnostic and therapeutic imaging technology has evolved in the last decade, increasing the complexity of imaging choices available for target localisation, and introducing soft tissue visualisation into the trea...

Involvement of parametrial disease in locally advanced cervical patients poses a challenge for women undergoing brachytherapy. Current use of the Fletcher suit applicator may not adequately cover the high risk clinical target volume (HR CTV), especially in the parametrial region due to the physical qualities of brachytherapy from the inverse square law and the need to respect organs at risk (OA...

Three dimensional planning for high-dose-rate (HDR) brachytherapy in cervical cancer has been highly recommended by consensus guidelines such as the American Brachytherapy Society (ABS) and the Groupe Européen de Curiethérapie - European Society for Radiotherapy and Oncology (GEC-ESTRO). In this document, we describe our experience with computed tomography (CT)-based planning using the tandem/r...