title: Three-dimensional treatment planning for vaginal cuff brachytherapy: dosimetric effects on organs at risk according to patients position.
abstract: OBJECTIVE
  Aim of this study was to evaluate dose distribution within organs at risk (OARs) and planning target volume (PTV) based on three-dimensional treatment planning according to two different setup positions in endometrial carcinoma patients submitted to postoperative brachy-radiotherapy on vaginal vault.
  
  
  METHODS
  Patients with endometrial cancer necessitating of adjuvant brachytherapy on vaginal vault were enrolled. Pelvic computed tomography studies were prospectively obtained in two different setup positions: extend legs (A position) and gynecological (B position). Contoured OARs were bladder, rectum, and small bowel. The PTV was identified as applicator's surface with an isotropic 5-mm margin expansion. Radiation dose delivered in 1 cc (D1cc) and 2 cc (D2cc) of OAR were calculated.
  
  
  RESULTS
  Coverage of PTV and values of D1cc and D2cc obtained for bladder and small bowel were similar in the two positions. For rectum, both D1cc and D2cc had statistically significant lower values in A with respect to B position.
  
  
  CONCLUSIONS
  Both in A and B positions, radiation doses delivered do not exceed the dose constraints. However, A setup seems to significantly reduce doses to rectum while obtaining the same PTV coverage. The findings from our study provide evidence supporting the use of A position setup for delivering vaginal vault brachytherapy.
authors.affiliation: Operative Unit of Radiation Oncology, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iatì
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy. Electronic address: apontoriero@unime.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pontoriero
authors.affiliation: Department of Neuroscience, University of Messina, Messina, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Mondello
authors.affiliation: Operative Unit of Medical Physics, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Brogna
authors.affiliation: Operative Unit of Medical Physics, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Pasquale
authors.affiliation: Operative Unit of Medical Physics, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Isidora
authors.initials: I
authors.lastname: Ielo
authors.affiliation: Operative Unit of Radiation Oncology, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Potami
authors.affiliation: Operative Unit of Radiation Oncology, A.O.U. "G. Martino", Messina, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Messina
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
authors.forename: Costantino
authors.initials: C
authors.lastname: De Renzis
authors.affiliation: Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, Messina, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pergolizzi
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D019583:Dose Fractionation, Radiation; D016889:Endometrial Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D058958:Organs at Risk / Q000528:radiation effects*; D011829:Radiation Dosage; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012007:Rectum / Q000528:radiation effects; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000528:radiation effects; D014621:Vagina / Q000528:radiation effects
keywords: 3D planning; Brachytherapy; Set up position