S53
Brachytherapy - Gynaecology
ESTRO 2026
chemoradiotherapy including MRI guided adaptive brachytherapy at our clinic. To evaluate the quality of the treatments this study aims at comparing selected parameters with recently published quality indicators and recommendations. Material/Methods: Quality parameters for 165 patients with cervical cancer stage IB3-IVB (FIGO 2018) receiving (chemo)radiotherapy, all including brachytherapy, during 2020–2023, were collected retrospectively. The data were compared to recommendations from ESGO/ESTRO-group [1] and other guiding documents [2][3]. Results: Preliminary results comparing quality indicators QI1- QI19 (Table 1) from ESGO/ESTRO shows that the clinic fulfills 15 out of 19 during the investigated period and demonstrated improvements for two of the QI’s (QI14 and QI16). QI14 concerns brachytherapy after EBRT>36 Gy, which increased from 62% to 85% of the patients. For QI16, which assesses dose volume histogram achievability for targets and organs at risk (Figure 1), the fulfilment increased from 5/20 to 16/20. Quality improvement efforts including EQD2– summations and strive to fulfil the new recommendations made the clinic fulfill the majority of QI’s and to increase the number of fulfilled dose volume histogram achievability parameters from 25% to 80%. For QI3 and QI8 improvement is required on structural level and is an ongoing process. In comparing results from the summed mean EQD2 doses to targets and OAR’s per study year with the recommended dose planning aims from Tanderup et al [2], the preliminary result shows that the clinic fulfilled all of the recommendations for 2023. However, in 2020 only 8/9 of the hard constraints and 4/11 of the soft constraints were fulfilled. The clinic increased the number of fulfilled hard constraints with 12% and for soft constraints with 175%.Due to its potential connection to vaginal side effects [3], the vaginal TRAK was studied. During the study period, the vaginal TRAK decreased from 53% to 46% (p<0.05).
Conclusion: The proposed automated configuration planning method produces high-quality treatment plans that improve upon, or are comparable to, those for manually specified configurations. It could standardise and accelerate preplanning, while enabling clinicians to explore trade-offs in dosimetry and implant complexity. Keywords: Catheter optimisation, integer programming References: 1. Bélanger C, Aubin S, Lavallée MC, Beaulieu L. Simultaneous catheter and multicriteria optimization for HDR cervical cancer brachytherapy with a complex intracavity/interstitial applicator. Med Phys. 2024;51(3):2128-43.2. Straathof R, van Vliet-Pérez SM, Kolkman-Deurloo IK, Wauben LSGL, Nout RA, Heijmen BJM, et al. Automated planning of curved needle channels in 3D printed patient-tailored applicators for cervical cancer brachytherapy. Phys Med Biol. 2024;69(23).3. Rossi L, Bijman R, Chopra S, Mittal P, Panda S, Westerveld H, et al. Rule-based AI automated adaptive treatment planning for image guided cervical cancer brachytherapy. Brachytherapy. 2025;24(5):711-20. Mini-Oral 1343 Evaluation of quality parameters in combined chemoradiotherapy including MRI guided adaptive brachytherapy for locally advanced cervical cancer Jeanette Wolke 1 , Danyal Abdallah 2 , Kristina Hellman 2,3 , Åsa Carlsson Tedgren 1,3 1 Department of Nuclear Medicin and Radiation Physics, Karolinska University Hospital, Stockholm, Sweden. 2 Department of Gynecologic Cancer, Karolinska University Hospital, Stockholm, Sweden. 3 Department of Oncology Pathology, Karolinska Institute, Stockholm, Sweden
Purpose/Objective: Locally advanced cervical cancer is treated with
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