{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T02:05:12Z","timestamp":1777860312213,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Risk &amp; Safety in Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Image-guided brachytherapy became essential to cervical cancer treatment following chemo-radiotherapy. A variety of applicators including Tandem-Ring (TR) and Tandem-Ovoid (TO) applicators are used to apply brachytherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aims to dosimetrically compare TR versus TO applicators by using two different optimization techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Both applicator sets were applied to the 24 patients. The prescribed dose was 7\u00a0Gy\/fraction, and the treatment plans were normalized to HR-CTV. Two different optimization techniques are applied, along the four treatment fractions. The first optimization technique was a theoretical assumption that aimed to deliver 7\u00a0Gy to 90 % of the volume of the HR-CTV. While the second was the clinical situation which aimed to preserve the organs at risk (OARs) according to the ICRU 89 dose-volume constraints, considering that, 90% of HR-CTV is covered by not less than 90% of the prescribed dose. DVHs were generated, and dosimetric parameters including point A, and D2cc of rectum, bladder, and sigmoid, as well as the dose at different volumes of HR-CTV and IR-CTV, were recorded and compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The results demonstrate that using Ovoid-Tandem applicators achieved significantly higher dose at point A, significantly higher coverage to both HR-CTV and IR-CTV, in addition to significantly better protection to the mean D2cc of the rectum in both optimization techniques. On the other hand, using Ring-Tandem applicators give significantly more protection to the mean D2cc of the bladder, but HR-CTV and IR-CTV have significantly lower coverage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ovoid-Tandem and Ring-Tandem applicators are the most common interchangeable intracavitary gynecological applicators. In this study, the results demonstrated that Ovoid-Tandem applicators have the advantages of significantly higher coverage for HR-CTV, and IR-CTV, in addition to more protection for D2cc of the rectum. On the contrary, Ring-Tandem applicators can provide higher protection for D2cc of the bladder, and more comfort to the patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09246479251353380","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T03:30:42Z","timestamp":1750303842000},"page":"260-269","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative study of brachytherapy using ring and ovoid applicators in treatment of advanced cervical cancer"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4374-7212","authenticated-orcid":false,"given":"Reham S","family":"Sherif","sequence":"first","affiliation":[{"name":"Cairo University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hend M","family":"Kareem","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem H","family":"El-Gebaly","sequence":"additional","affiliation":[{"name":"Cairo University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A","family":"Shehata","sequence":"additional","affiliation":[{"name":"Menoufia University"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reham A A","family":"Aziz","sequence":"additional","affiliation":[{"name":"Menoufia University"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,19]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_4_3_2","volume-title":"Egypt, Human papillomavirus and related cancers","year":"2021","unstructured":"Egypt, Human papillomavirus and related cancers. Fact Sheet, 2021. https:\/\/www.hpvcenter.net"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.4103\/jrcr.jrcr_35_22"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2020.94308"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41241-018-0070-z"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brachy.2011.07.003"},{"issue":"1","key":"e_1_3_4_8_2","first-page":"39","article-title":"Dosimetric comparison of tandem and ovoids with tandem and ring for intracavitary brachytherapy for carcinoma cervix","volume":"46","author":"Vinin NV","year":"2019","unstructured":"Vinin NV, Dharmarajan A, Sahin PM, et al. Dosimetric comparison of tandem and ovoids with tandem and ring for intracavitary brachytherapy for carcinoma cervix. Oncology and Radiotherapy 2019; 46(1): 39\u201342.","journal-title":"Oncology and Radiotherapy"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rpor.2017.12.006"},{"key":"e_1_3_4_10_2","first-page":"451","article-title":"Dosimetric comparison of ring and ovoid applicators","volume":"14","author":"Tuncell N","year":"2009","unstructured":"Tuncell N, Toy ATSUN, Demiral AN, et al. Dosimetric comparison of ring and ovoid applicators. 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J Med Phys 2017; 42(suppl. 1): 48.","journal-title":"J Med Phys"},{"key":"e_1_3_4_15_2","first-page":"1566","article-title":"Impact of brachytherapy applicators geometry on dose distribution in gynecological cancer","volume":"66","author":"Rehman AU","year":"2016","unstructured":"Rehman AU, Buzdar SA, Hassan M, et al. Impact of brachytherapy applicators geometry on dose distribution in gynecological cancer. J Pak Med Assoc 2016; 66: 1566\u20131570.","journal-title":"J Pak Med Assoc"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2015.51853"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2008.06.003"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.5114\/jcb.2017.70677"},{"issue":"3","key":"e_1_3_4_19_2","first-page":"698","article-title":"Long-term clinical outcome and dosimetric comparison of tandem and ring versus tandem and ovoids intracavitary application in cervical cancer. 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