Comparison of high-dose-rate intracavitary brachytherapy dosimetry with and without anesthesia in patients with cervical carcinoma.

This study compares the dosimetry of high-dose-rate intracavitary brachytherapy (HDR-ICBT) performed with and without general anesthesia/spinal anesthesia (GA/SA) in patients with cervical carcinoma. We retrospectively retrieved the records of 138 HDR-ICBT applicator insertions performed in 46 patients: 69 performed with GA/SA (anesthesia group known as AG) in 23 patients, and 69 performed without GA/SA (nonanesthesia group known as NAG) in 23 patients. The intracavitary brachytherapy (ICBT) application was done with central tandem and two vaginal ovoids. For each ICBT plan, a high-dose-rate (HDR) dose of 7 Gy was prescribed to point A. From each plan, the doses to Point B right (B(R)), Point B left (B(L)), bladder and rectal reference points (Bladder(ref) and Rectal(ref)) were recorded and compared in the two groups. Student's t-test was applied to find out the significance of difference. The two groups were comparable in terms of demography and clinical characteristics. Mean Point BL doses in AG and NAG were 1.89 Gy (27% of Point A dose) and 1.82 Gy (26% of Point A dose), respectively. Mean Point BR doses in AG and NAG were 1.91 Gy (27% of Point A dose) and 1.85 Gy (26% of point A), respectively (p-value 0.7). The mean dose to Bladder(ref) in AG and NAG was 5.03 Gy and 4.90 Gy, respectively (p-value 0.6). The mean dose to Rectal(ref) was significantly higher in AG than NAG (5.09 Gy vs. 4.49 Gy, p-value 0.01). Although based on conventional 2D dosimetry planning, our study has demonstrated that avoiding GA/SA does not result in inferior HDR-ICBT dosimetry.