{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T21:40:00Z","timestamp":1757454000804,"version":"3.44.0"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T00:00:00Z","timestamp":1726012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Endometrial cancer is one of the most common gynecological malignancies in the world. Vaginal brachytherapy is an important postoperative adjuvant treatment for endometrial cancer. However, a common problem with existing applicators is insufficient dose at the vaginal apex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study describes the Hangzhou (HZ) cylinder, a novel 3D printed vaginal intracavity brachytherapy applicator, detailing its characteristics, dose distribution, and clinical applications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Materials<\/jats:title><jats:p>The HZ cylinder is distinguished by its unique structure: a U\u2010shaped channel with a 2\u00a0mm diameter, a straight central axis channel of the same diameter, and 10 parallel straight channels. For comparison, standard plans were employed, designed to ensure that a minimum of 95% of the prescribed dose reached 5\u00a0mm beneath the mucosal surface. We conducted comparative analyses of mucosal surface doses and doses at a 5\u00a0mm depth below the mucosa between the HZ cylinder and a conventional single\u2010channel cylinder across various treatment schemes. Additionally, the study examined dose differences in target volume and organs at risk (OARs) between actual HZ cylinder plans and hypothetical single\u2010channel plans.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the standard plans, mucosal surface doses at the apex of the vagina were 209.32% and 200.61% of the prescribed dose with the HZ and single\u2010channel cylinders, respectively. The doses on the left and right wall mucosal surfaces varied from 149.26% to 178.13% and 142.98% to 180.75% of the prescribed dose, and on the anterior and posterior wall mucosal surfaces varied from 128.87% to 138.50% and 142.98% to 180.75% of the prescribed dose. Analysis of 24 actual treatment plans revealed that when the vaginal tissue volume dose covering 98% (vaginal D98%) was comparable between the HZ cylinder and virtual single\u2010channel plans (6.74\u00a0\u00b1\u00a00.07\u00a0Gy vs. 6.69\u00a0\u00b1\u00a00.10\u00a0Gy, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.24), rectum doses of HZ cylinder plans were significantly lower than those of single\u2010channel plans (D1cc, 5.96\u00a0\u00b1\u00a00.56\u00a0Gy vs. 6.26\u00a0\u00b1\u00a00.71\u00a0Gy, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02 and D2cc, 5.26\u00a0\u00b1\u00a00.52\u00a0Gy vs. 5.56\u00a0\u00b1\u00a00.62\u00a0Gy, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The HZ cylinder demonstrates a reduction in dose to the rectum and bladder while maintaining adequate target volume coverage. Its mucosal surface dose is comparable to that of the traditional single\u2010channel cylinder. These findings suggest that the HZ cylinder is a viable and potentially safer alternative for vaginal brachytherapy, warranting further investigation with larger sample sizes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14521","type":"journal-article","created":{"date-parts":[[2024,9,11]],"date-time":"2024-09-11T15:38:54Z","timestamp":1726069134000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A novel multi\u2010channel applicator with a U\u2010shaped channel for vaginal intracavity brachytherapy"],"prefix":"10.1002","volume":"25","author":[{"given":"Yanfei","family":"Lu","sequence":"first","affiliation":[{"name":"Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangfang","family":"Wang","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6706-3925","authenticated-orcid":false,"given":"Xiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Zhejiang Cancer Hospital  Hangzhou Zhejiang China"},{"name":"Hangzhou Institute of Medicine (HIM) Chinese Academy of Sciences  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)62163-2"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2011.08.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clon.2022.08.034"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/CMAR.S119125"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines9111629"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2016.04.005"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1120\/jacmp.v14i1.4098"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2022.06.001"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(98)00014-5"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(94)00326-G"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2005.02.002"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.1646040"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2019.02.008"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.10.041"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1538-4721(02)00051-X"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2021.112120"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2018.79713"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11547-022-01455-y"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2021.100773"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2014.12.006"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2018.78832"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2023.02.002"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.235"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2021.112115"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2016.08.016"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.14521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T16:43:55Z","timestamp":1756140235000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.14521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,11]]},"references-count":26,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/acm2.14521"],"URL":"https:\/\/doi.org\/10.1002\/acm2.14521","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"type":"print","value":"1526-9914"},{"type":"electronic","value":"1526-9914"}],"subject":[],"published":{"date-parts":[[2024,9,11]]},"assertion":[{"value":"2024-05-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14521"}}