Br J Radiol. 2026 May 21:tqag075. doi: 10.1093/bjr/tqag075. Online ahead of print.
ABSTRACT
OBJECTIVE: To compare virtual straight and bending rods Spatially Fractionated Radiation Therapy (SFRT) for cervical cancer brachytherapy delivery.
METHODS: CT scan datasets from ten patients with locally advanced cervical cancer who received brachytherapy were included. For each patient, two distinct plans were generated: one using straight virtual rods and the other using bending virtual rods. The total prescribed dose was 30 Gy in 5 fractions. All plans were created with 10XFFF beam. Dosimetric parameters, including D90, V100, V150, and V200 for high risk-clinical target volume (HRCTV), were evaluated. Additionally, dose constraints for OARs (bladder, rectum, sigmoid, and bowel D2cc) were compared. Plan delivery quality assurance was performed for using Mobius verification phantom, and gamma passing rate was analyzed.
RESULTS: Comparable CTV coverage was observed between the two configurations. D90 values showing no statistically significant difference (p > 0.05). In both plans, the D2cc ofbladder, rectum, sigmoid, and bowel were observed to be ≤ 23.75 Gy, ≤ 17.00 Gy, ≤ 19.50 Gy, and ≤ 17.00 Gy, respectively. The average hotspot in HRCTV was evaluated at 18.4% (±10.4) and 20.8% (±7.8) for V200%, respectively. The gamma passing rate was found to be greater than 90% for the 2%/2 mm criteria.
CONCLUSION: This in-silico study concludes that both virtual rod configurations provide comparable target coverage while effectively minimizing OAR exposure. Further clinical validation is recommended to confirm these findings.
ADVANCES IN KNOWLEDGE: This study demonstrates the feasibility of SFRT and the potential for future testing in patients who are unable to undergo brachytherapy.
PMID:42179164 | DOI:10.1093/bjr/tqag075
