Eng T Y, Patel A J, Ha C S
Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Department of Radiation Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Brachytherapy. 2016 May-Jun;15(3):312-318. doi: 10.1016/j.brachy.2016.02.008. Epub 2016 Mar 28.
The use of intravaginal Foley balloons in addition to conventional packing during high-dose-rate (HDR) tandem and ovoids intracavitary brachytherapy (ICBT) is a means to improve displacement of organs at risk, thus reducing dose-dependent complications. The goal of this project was to determine the reduction in dose achieved to the bladder and rectum with intravaginal Foley balloons with CT-based planning and to share our packing technique.
One hundred and six HDR-ICBT procedures performed for 38 patients were analyzed for this report. An uninflated Foley balloon was inserted into the vagina above and below the tandem flange separately and secured in place with vaginal packing. CT images were then obtained with both inflated and deflated Foley balloons. Plan optimization occurred and dose volume histogram data were generated for the bladder and rectum. Maximum dose to 0.1, 1.0, and 2.0 cm(3) volumes for the rectum and bladder were analyzed and compared between inflated and deflated balloons using parametric statistical analysis.
Inflation of intravaginal balloons allowed significant reduction of dose to the bladder and rectum. Amount of reduction was dependent on the anatomy of the patient and the placement of the balloons. Displacement of the organs at risk by the balloons allowed an average of 7.2% reduction in dose to the bladder (D0.1 cm(3)) and 9.3% to the rectum (D0.1 cm(3)) with a maximum reduction of 41% and 43%, respectively.
For patients undergoing HDR-ICBT, a significant dose reduction to the bladder and rectum could be achieved with further displacement of these structures using intravaginal Foley balloons in addition to conventional vaginal packing.
在高剂量率（HDR）串联和卵圆体腔内近距离放射治疗（ICBT）期间，除了传统填塞之外使用阴道内 Foley 球囊是一种改善危及器官移位的方法，从而减少剂量依赖性并发症。本项目的目标是通过基于 CT 的计划确定使用阴道内 Foley 球囊时膀胱和直肠所获得的剂量降低，并分享我们的填塞技术。
本报告分析了为 38 名患者进行的 106 例 HDR-ICBT 程序。将未充气的 Foley 球囊分别插入串联凸缘上方和下方的阴道内，并用阴道填塞固定到位。然后在 Foley 球囊充气和未充气的情况下获取 CT 图像。进行计划优化，并生成膀胱和直肠的剂量体积直方图数据。使用参数统计分析对直肠和膀胱的 0.1、1.0 和 2.0 cm³ 体积的最大剂量进行分析和比较，比较充气和未充气球囊的情况。
阴道内球囊充气可显著降低膀胱和直肠的剂量。降低量取决于患者的解剖结构和球囊的放置位置。球囊对危及器官的移位使膀胱剂量（D0.1 cm³）平均降低 7.2%，直肠剂量（D0.1 cm³）平均降低 9.3%，最大降低分别为 41%和 43%。
对于接受 HDR-ICBT 的患者，除了传统的阴道填塞外，使用阴道内 Foley 球囊进一步移位这些结构可显著降低膀胱和直肠的剂量。
