ArticleRadiation oncology (London, England)2024
Pelvic target volume inter-fractional motion during radiotherapy for cervical cancer with daily iterative cone beam computed tomography.
Article in Radiation oncology (London, England), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Interfractional variability and reproducibility of accumulated dose in cervical cancer radiotherapy associated with bladder volume.Radiological physics and technology · 2026Article
- Commissioning and verification of a 3D Monte Carlo independent calculation software for O-ring linac systems.Journal of applied clinical medical physics · 2026Article
- Platform-specific comparison of IMRT and VMAT angular resolution for Ethos-based online adaptive radiotherapy in cervical cancer.Frontiers in oncology · 2026Article
- From Host-Microbiome Symbiosis to Clinical Translation: A Gut Microbiome Perspective on Radiation Enteritis.International journal of biological sciences · 2026Review
- Dosimetric effects of bladder volume changes in MR-guided radiotherapy for cervical cancer.BMC cancer · 2025Article
- Assessing intra- and interfraction motion and its dosimetric impacts on cervical cancer adaptive radiotherapy based on 1.5T MR-Linac.Radiation oncology (London, England) · 2024Article
- Moderated Hypofractionated Online Adaptive Radiotherapy in Locally Advanced Cervical Cancer: A Case Report.Cureus · 2024Article
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6 authors.
Funding
Abstract
backgroundTumor regression and organ movements indicate that a large margin is used to ensure target volume coverage during radiotherapy. This study aimed to quantify inter-fractional movements of the uterus and cervix in patients with cervical cancer undergoing radiotherapy and to evaluate the clinical target volume (CTV) coverage.
methodsThis study analyzed 303 iterative cone beam computed tomography (iCBCT) scans from 15 cervical cancer patients undergoing external beam radiotherapy. CTVs of the uterus (CTV-U) and cervix (CTV-C) contours were delineated based on each iCBCT image. CTV-U encompassed the uterus, while CTV-C included the cervix, vagina, and adjacent parametrial regions. Compared with the planning CTV, the movement of CTV-U and CTV-C in the anterior-posterior, superior-inferior, and lateral directions between iCBCT scans was measured. Uniform expansions were applied to the planning CTV to assess target coverage.
resultsThe motion (mean ± standard deviation) in the CTV-U position was 8.3 ± 4.1 mm in the left, 9.8 ± 4.4 mm in the right, 12.6 ± 4.0 mm in the anterior, 8.8 ± 5.1 mm in the posterior, 5.7 ± 5.4 mm in the superior, and 3.0 ± 3.2 mm in the inferior direction. The mean CTV-C displacement was 7.3 ± 3.2 mm in the left, 8.6 ± 3.8 mm in the right, 9.0 ± 6.1 mm in the anterior, 8.4 ± 3.6 mm in the posterior, 5.0 ± 5.0 mm in the superior, and 3.0 ± 2.5 mm in the inferior direction. Compared with the other tumor (T) stages, CTV-U and CTV-C motion in stage T1 was larger. A uniform CTV planning treatment volume margin of 15 mm failed to encompass the CTV-U and CTV-C in 11.1% and 2.2% of all fractions, respectively. The mean volume change of CTV-U and CTV-C were 150% and 51%, respectively, compared with the planning CTV.
conclusionsMovements of the uterine corpus are larger than those of the cervix. The likelihood of missing the CTV is significantly increased due to inter-fractional motion when utilizing traditional planning margins. Early T stage may require larger margins. Personal radiotherapy margining is needed to improve treatment accuracy.
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