Feasibility Study of Robust Optimization to Reduce Dose Delivery Uncertainty by Potential Applicator Displacements for a Cervix Brachytherapy

• Published in: Applied sciences Vol. 11; no. 6; p. 2592
• Main Authors: Jo, Byungdu, Park, Kyeongyun, Shin, Dongho, Lim, Young Kyung, Jeong, Jong Hwi, Lee, Se Byeong, Kim, Hee-Joung, Kim, Haksoo
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.03.2021
• Subjects: Algorithms; Bladder; Brachytherapy; Cancer therapies; Cervical cancer; Chemotherapy; Computed tomography; Displacement; Dosage; Dosimetry; Feasibility studies; Genetic algorithms; high dose rate brachytherapy; Magnetic resonance imaging; median absolute deviation; Mortality; Optimization; Optimization algorithms; Optimization techniques; Organs; Patients; Planning; Radiation dosage; Radiation therapy; robust optimization; single plan approach; Uncertainty; Sweden
• ISSN: 2076-3417; 2076-3417
• DOI: 10.3390/app11062592

Brachytherapy is an important technique to increase the overall survival of cervical cancer patients. However, a possible shift of the applicators in relation to the target and organs at risk may occur between imaging and treatment. Without daily adaptive brachytherapy planning, these applicator displacements can lead to a significant change in dose distribution. In order to resolve it, a robust optimization method had been developed using a genetic algorithm combined with a median absolute deviation as a robustness evaluation function. The resulting robustness plans from our strategy might be worth considering according to the GEC-ESTRO guidelines. From the point of view of dose delivery uncertainty from applicator displacement, the robust optimization may be considered with caution in a single-plan approach for High Dose Rate brachytherapy treatment planning and should be confirmed by a more thorough investigation.