ESTRO 2024 - Abstract Book

S251

Brachytherapy - Gynaecology

ESTRO 2024

Keywords: Interstitial brachytherapy, cervical cancer

References:

Fokdal, L., Sturdza, A., Mazeron, R., Haie-Meder, C., Tan, L.T., Gillham, C., Šegedin, B., Jürgenliemk-Schultz, I., Kirisits, C., Hoskin, P., Pötter, R., Lindegaard, J.C. and Tanderup, K. (2016). Image guided adaptive brachytherapy with combined intracavitary and interstitial technique improves the therapeutic ratio in locally advanced cervical cancer: Analysis from the retroEMBRACE study. Radiotherapy and Oncology, 120(3), pp.434–440. doi:https://doi.org/10.1016/j.radonc.2016.03.020. Chargari, C., Tanderup, K., François Planchamp, Chiva, L., Humphrey, P., Sturdza, A., Li Tee Tan, van, Zapardiel, I., Nout, R.A. and Fotopoulou, C. (2023). ESGO/ESTRO quality indicators for radiation therapy of cervical cancer. Radiotherapy and Oncology, 183, pp.109589–109589. doi:https://doi.org/10.1016/j.radonc.2023.109589. Kamrava, M., Alrashidi, S.M. and Leung, E. (2021). Interstitial brachytherapy for gynecologic malignancies: Complications, toxicities, and management. Brachytherapy, [online] 20(5), pp.995–1004. doi:https://doi.org/10.1016/j.brachy.2020.12.008.

1284

Digital Poster

The significance of free hand needles in cervical cancer brachytherapy

Jan-Erik Palmgren 1 , Ester Jääskeläinen 2 , Jan Seppälä 1 , Maarit Anttila 2

1 KUH, Radiotherapy, Kuopio, Finland. 2 KUH, obstetrics and gynaecology, Kuopio, Finland

Purpose/Objective:

In cervical cancer brachytherapy part of the target volume might be unapproachable by applicator and it’s predefined needle positions. With such cases there is an option to insert free hand needles outside of the standard locations in the applicator. With these needles there are less limitations to the position, angle and depth and the target volumes may be better approachable. However, the free hand needle technique demands also more expertise from the operator, and it is of great importance to knowledge the benefits of using free hand needles.

The aim of this retrospective study was to investigate the dosimetric impact of the free hand needles which in our knowledge has not been investigated earlier.

Material/Methods:

24 locally advanced cervical cancer patients treated between 2016–2020 with free hand needles in their brachytherapy plans were replanned without using free hand needles. The average volume of the high risk clinical target volume (HR-CTV) was 69,7 cm3 (16,5-160,2 cm3). Patients were treated according to GEC-ESTRO guidelines [1,2] with 3D MRI guided brachytherapy boost (4 x 7 Gy) and EBRT chemoradiotherapy (25 – 28 x 1,8 - 2,1 Gy). For each brachytherapy fraction a new applicator and needle implantation, MR-imaging and treatment plan was made. If needed, the applicator configuration, number, position and / or depth of the needles were adjusted with each fraction. Venzia™ or interstitial ring™ applicator from ELEKTA were used. For this study, every fraction was