Priean V Gogul, Aggarwal Lalit Mohan, Mourya Ankur, Choudhary Sunil, Shajid Syed M, Mandal Abhijit, Singh Ankita
Department of Radiotherapy and Radiation Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Radiotherapy, State Cancer Institute, N.S.C.B Medical College, Jabalpur, Madhya Pradesh, India.
J Cancer Res Ther. 2025 Apr 1;21(3):576-582. doi: 10.4103/jcrt.jcrt_1335_24. Epub 2025 Jul 5.
To compare the effectiveness of the inverse planning simulated annealing (IPSA) and hybrid inverse planning optimization (HIPO) algorithms in interstitial HDR brachytherapy for treatment of cervical cancer.
A dosimetric study was conducted on 46 cervical cancer patients who underwent multi catheter interstitial cervical HDR brachytherapy using the Martinez Universal Perineal Interstitial Template (MUPIT). Dosimetric parameters, plan evaluation indices, and mean treatment time were assessed for each algorithm. All the parameters were compared using statistical analysis.
With HIPO, significant improvements were observed in D90, D100, V100, and V200 (P < 0.05). Additionally, HIPO plans demonstrated lower doses to the bladder (B2cc) as compared to IPSA plans, whereas IPSA plans exhibited lower rectum (R2cc) and sigmoid (S2cc) doses, with statistical significance observed only for sigmoid doses. HIPO plans had better results in the plan evaluation indices such as CI, COIN, DHI, DNR, ODI, EI, NV100, GFB, GFR, GF, PQI1, PQI2, and PQS with statistical significance (P < 0.05) except for GFS. Moreover, HIPO plans had shorter mean treatment time compared to IPSA plans by 5.52 seconds, although this difference did not reach statistical significance. It was found that HIPO plans demonstrated superior dose-volumetric parameters for the high-risk clinical target volume (HR-CTV).
In conclusion, HIPO emerged as the preferred algorithm for interstitial cervical HDR brachytherapy due to improved dose distribution in HR-CTV and plan quality as well.
比较逆向计划模拟退火（IPSA）算法和混合逆向计划优化（HIPO）算法在宫颈癌组织间高剂量率近距离治疗中的有效性。
对46例接受使用马丁内斯通用会阴组织间模板（MUPIT）进行多导管组织间宫颈高剂量率近距离治疗的宫颈癌患者进行剂量学研究。评估每种算法的剂量学参数、计划评估指标和平均治疗时间。使用统计分析对所有参数进行比较。
采用HIPO算法时，D90、D100、V100和V200有显著改善（P < 0.05）。此外，与IPSA计划相比，HIPO计划显示膀胱（B2cc）接受的剂量更低，而IPSA计划直肠（R2cc）和乙状结肠（S2cc）接受的剂量更低，仅乙状结肠剂量具有统计学意义。HIPO计划在计划评估指标如CI、COIN、DHI、DNR、ODI、EI、NV100、GFB、GFR、GF、PQI1、PQI2和PQS方面有更好的结果，具有统计学意义（P < 0.05），除了GFS。此外，HIPO计划的平均治疗时间比IPSA计划短5.52秒，尽管这种差异未达到统计学意义。研究发现，HIPO计划在高危临床靶区（HR-CTV）的剂量-体积参数方面表现更优。
总之，由于在HR-CTV中剂量分布改善以及计划质量提高，HIPO成为宫颈组织间高剂量率近距离治疗的首选算法。
