S81
Brachytherapy - Gynaecology
ESTRO 2026
IO (p:0.009, p:0.003, p<0.001, p<0.001, p:0.001, respectively). Cumulative rectum, bowel, and vaginal D2cc doses were also significantly lower in RPO compared to only RLO (p:0.006, p:0.008, p:0.018, respectively).
cancer patients who underwent vaginal cuff (VC) brachytherapy (BT) using an ovoid applicator. Material/Methods: Computed tomography (CT)-simulation images of 13 patients who received VC BT with an ovoid applicator following adjuvant external beam radiotherapy (EBRT) were used. Treatment plans were generated using three optimization techniques to compare dose to CTVcuff and OARs. In RPO, reference point was defined 0.5 cm lateral to the intersection of the line passing through the center of the ovoid applicators and the lateral vaginal wall. In RLO, reference line was created by connecting 11 points located 0.5 cm from the apex and lateral walls of the ovoid applicators (Fig.1). In IO, dose was prescribed to CTVcuff. In IO CTVcuff coverage was aimed with goals of D ₉₈ > 85%, D ₉₀ > 100%, and V ₁₀₀ > 92.5%, while cumulative D2cc EQD23Gy doses to OARs were constrained to <9000 cGy (bladder), <7500 cGy (sigmoid and rectum), and <6500 cGy (bowel). Descriptive statistics were presented as median (min–max). The effects of optimization techniques on dependent variables (CTV dose-volume parameters, CTVcuff indices, and OAR Dcc doses) were compared using Friedman test with Bonferroni post-hoc correction. Statistical analyses were performed using SPSS version 24.
Conclusion: In terms of CTVcuff coverage, RPO is clearly inferior to both RLO and IO techniques. Although not statistically significant, IO seemed to provide better CTVcuff D ₉₀ compared to RLO. It should be noted that all techniques complied with the recommended OAR Dcc dose constraints across all patients. Keywords: Vaginal cuff brachytherapy, ovoid, optimization Feasibility and Efficacy of MRI-Guided Adaptive Brachytherapy for locally Advanced Cervical Cancer: A Prospective Cohort Study Fatma A. Rikabe 1,2 , Abdelrahman Gouda 3,2 , Abdelrhman H. Mohamed 4 , Mohamed Soliman Gaber 5 , Abdullah Khalil 2 , A.R. Mohamed 2 , Mohamed Mahmoud 2,6 1 Department of Clinical Oncology, Faculty of Medicine, Luxor University, Luxor, Egypt. 2 Department of Digital Poster 4643 Radiation Oncology, Shefaa Al-Orman Hospital, Luxor, Egypt. 3 Department of Clinical Oncology, Faculty of Medicine, Aswan University, Aswan, Egypt. 4 Faculty of medicine, Luxor university, Luxor, Egypt. 5 Department of Clinical Oncology, Faculty of medicine, Sohag
Results: Median CTVcuff D ₉₀ values for RPO, RLO, and IO were 92.7%, 97.2%, and 99.7%, respectively. CTVcuff D ₉₀ and D ₉₈ were significantly lower with RPO compared to IO and RLO (p:0.009 and p:0.003, respectively). Mean CTVcuff dose in RPO was also significantly lower than in RLO (p:0.008). Only DNR and OI showed significant differences in RPO compared to IO and RLO, indicating lower DNR and higher OI (both p<0.001). Cumulative rectum D0.1cc, D1cc, sigmoid D0.1cc, D1cc and D2cc were significantly lower in RPO compared to RLO and
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