Advanced Brachytherapy Physics - Vienna 2016

Inter-/intrafraction variation in cervix cancer BT 1 plan evaluated for images at different time points. Anatomical changes between irradiations may lead to large random dosimetric uncertainties Inter-/intrafraction variation in cervix cancer BT Klug F1 Klug F2 fraction 1 fraction 2 fraction 3 fraction 4

© Lang et al 2013 Radiother Oncol 107 . ,

variation

# patients treatment

fractions

time range

Image type

images

1 2 3 4 5 6

21 21

HDR HDR PDR HDR HDR PDR

4 3

18-20 hrs

MRI MRI MRI

84 72 36 69 54 62

Intra-app.

5 hrs

I t n ra-app.

9

2 x 29 / 32

22 hrs

Intra-app.

14 27 31

5 4

1-22 days 7-10 days

CT

Inter-app.

MRI MRI

Inter-app.

2 x 20

1 week

Inter-app.

123 patients

5 h – 3 weeks

377

3 + 3

Nesvacil et al. 2013, R&O 107