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The D\u2010RSBT planning is separated into two stages: anchor plan optimization and optimal sequencing. In the anchor plan optimization, anchor plans are generated by maximizing the<jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> for the high\u2010risk clinical\u2010tumor\u2010volume (HR\u2010CTV) assuming a fixed azimuthal emission angle of 11.25\u00b0. In the optimal sequencing, treatment plans that most closely approximate the anchor plans under the delivery\u2010time constraint will be efficiently computed. Treatment plans for five cervical cancer patients were generated for D\u2010RSBT, single\u2010shield RSBT (S\u2010RSBT), and <jats:sup>192<\/jats:sup>Ir\u2010based intracavitary brachytherapy with supplementary interstitial brachytherapy (IS + ICBT) assuming five treatment fractions. External beam radiotherapy doses of 45 Gy in 25 fractions of 1.8 Gy each were accounted for. The high\u2010risk clinical target volume (HR\u2010CTV) doses were escalated such that the <jats:italic>D<\/jats:italic><jats:sub>2cc<\/jats:sub> of the rectum, sigmoid colon, or bladder reached its tolerance equivalent dose in 2 Gy fractions (EQD2 with <jats:italic>\u03b1<\/jats:italic>\/<jats:italic>\u03b2<\/jats:italic> = 3 Gy) of 75 Gy, 75 Gy, or 90 Gy, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Results:<\/jats:bold><\/jats:title><jats:p>For the patients considered, IS + ICBT had an average total dwell time of 5.7 minutes\/fraction (min\/fx) assuming a 10 Ci<jats:sup>192<\/jats:sup> Ir source, and the average HR\u2010CTV <jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> was 78.9 Gy. In order to match the HR\u2010CTV <jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> of IS + ICBT, D\u2010RSBT required an average of 10.1 min\/fx more delivery time, and S\u2010RSBT required 6.7 min\/fx more. If an additional 20 min\/fx of delivery time is allowed beyond that of the IS + ICBT case, D\u2010RSBT and S\u2010RSBT increased the HR\u2010CTV <jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> above IS + ICBT by an average of 16.3 Gy and 9.1 Gy, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:bold>Conclusions:<\/jats:bold><\/jats:title><jats:p>For cervical cancer patients, D\u2010RSBT can boost HR\u2010CTV<jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> over IS + ICBT and S\u2010RSBT without violating the tolerance doses to the bladder, rectum, or sigmoid. The <jats:italic>D<\/jats:italic><jats:sub>90<\/jats:sub> improvements from D\u2010RSBT depend on the patient, the delivery time budget, and the applicator structure.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4828778","type":"journal-article","created":{"date-parts":[[2013,11,7]],"date-time":"2013-11-07T23:05:47Z","timestamp":1383865547000},"update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":21,"title":["Dynamic rotating\u2010shield brachytherapy"],"prefix":"10.1002","volume":"40","author":[{"given":"Yunlong","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryan 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