{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:27:57Z","timestamp":1786649277575,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,10]]},"abstract":"\n Aim:<\/jats:title>\n Brachytherapy is an integral part of the management of carcinoma cervix. High-dose-rate intracavitary brachytherapy (HDR ICBT) is often delivered after external beam radiotherapy (EBRT) in more than one session. The uncertainties may arise due to variations in anatomy and applicator position during each session, which may impact dose distribution to the clinical target volume (CTV) and normal organs. This study aims to quantify interfraction dose variations in HDR ICBT for cervical cancer patients using computed tomography-based planning.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n In this retrospective study, 30 patients with carcinoma cervix of the International Federation of Gynecology and Obstetrics stage IB2 to IVA after EBRT were included in the study. Total dose for ICBT was 21 Gy delivered in 3 weekly fractions. Doses to CTV, Point A, Point B, and normal organs (rectum, bladder, and sigmoid colon) were recorded in each session. Statistical analysis was conducted using the Chi-square test to compare dose variations between fractions, with a significance level set at\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Mean dose received by 90% of the CTV was 5.92 Gy, 5.77 Gy, and 6.05 Gy for the first, second, and third fractions, respectively. Doses to 0.1 cc of bladder were 8.02 Gy, 7.17 Gy, and 7.51 Gy across fractions, whereas for 1 cc, doses were 6.17 Gy, 5.88 Gy, and 6.15 Gy, respectively. For 1 cc of rectum, doses were 5.60 Gy, 4.90 Gy, and 5.23 Gy, and for 2 cc, 5.17 Gy, 4.34 Gy, and 4.71 Gy, respectively, for three fractions. Sigmoid doses had relatively stable dose variation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Bladder, rectal, and sigmoid doses varied considerably across fractions, emphasizing the need for strict organ preparation protocols and adaptive dose monitoring.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jmp.jmp_162_25","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T20:00:33Z","timestamp":1767211233000},"page":"709-713","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Interfraction Dose Discrepancies in Organs at Risk, Clinical Target Volume, and Points A and B in Computed Tomography-based High-dose-rate Intracavitary Brachytherapy for Cervical Cancer Patients"],"prefix":"10.4103","volume":"50","author":[{"given":"Vishwadeep","family":"Mishra","sequence":"first","affiliation":[{"name":"Department of Radiotherapy, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laxman","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankita","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachita","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, BRD Medical College, Gorakhpur, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudeep","family":"Chanda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Archana","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Rohilkhand Medical College, Bareilly, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,12,31]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1002\/ijc.33588","article-title":"Cancer statistics for the year 2020: An overview","volume":"149","author":"Ferlay","year":"2021","journal-title":"Int J Cancer"},{"key":"R2-20260420","first-page":"CD002225","article-title":"Concomitant chemotherapy and radiation therapy for cancer of the uterine cervix","volume":"2005","author":"Green","year":"2005","journal-title":"Cochrane Database Syst Rev"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.radonc.2007.04.012","article-title":"Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer","volume":"83","author":"P\u00f6tter","year":"2007","journal-title":"Radiother Oncol"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/j.radonc.2016.08.007","article-title":"Image guided adaptive brachytherapy in cervix cancer: A new paradigm changing clinical practice and outcome","volume":"120","author":"Tanderup","year":"2016","journal-title":"Radiother Oncol"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/j.ijrobp.2004.04.032","article-title":"Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: Report from image-guided brachytherapy working group","volume":"60","author":"Nag","year":"2004","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R6-20260420","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1016\/j.ijrobp.2006.12.021","article-title":"Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy: Results of a prospective trial and preliminary guidelines for standardized contours","volume":"68","author":"Viswanathan","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1097\/00001622-199311000-00010","article-title":"High-dose rate brachytherapy for carcinoma of the cervix","volume":"5","author":"Arterbery","year":"1993","journal-title":"Curr Opin Oncol"},{"key":"R8-20260420","first-page":"NP","volume":"13","year":"2013","journal-title":"J ICRU"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.2147\/CMAR.S520276","article-title":"A retrospective analysis comparing the dosimetric parameters of two rectum-sparing techniques during intracavitary brachytherapy with tandem-ring applicators for cervical cancer","volume":"17","author":"Vats","year":"2025","journal-title":"Cancer Manag Res"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/S1470-2045(20)30753-1","article-title":"MRI-guided adaptive brachytherapy in locally advanced cervical cancer (EMBRACE-I): A multicentre prospective cohort study","volume":"22","author":"P\u00f6tter","year":"2021","journal-title":"Lancet Oncol"},{"key":"R11-20260420","first-page":"48","article-title":"The embrace II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies","volume":"9","author":"P\u00f6tter","year":"2018","journal-title":"Clin Transl Radiat Oncol"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/S0167-8140(03)00189-0","article-title":"Bladder and rectum dose defined from MRI based treatment planning for cervix cancer brachytherapy: Comparison of dose-volume histograms for organ contours and organ wall, comparison with ICRU rectum and bladder reference point","volume":"68","author":"Wachter-Gerstner","year":"2003","journal-title":"Radiother Oncol"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"1424","DOI":"10.1016\/j.ijrobp.2011.04.044","article-title":"Clinical use of the Utrecht applicator for combined intracavitary\/interstitial brachytherapy treatment in locally advanced cervical cancer","volume":"82","author":"Nomden","year":"2012","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.radonc.2009.06.032","article-title":"Sigmoid dose using 3D imaging in cervical-cancer brachytherapy","volume":"93","author":"Holloway","year":"2009","journal-title":"Radiother Oncol"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.radonc.2016.06.006","article-title":"Dose-volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study","volume":"120","author":"Mazeron","year":"2016","journal-title":"Radiother Oncol"}],"container-title":["Journal of Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmp.jmp_162_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:51:44Z","timestamp":1786647104000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmp.jmp_162_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jmp.jmp_162_25","relation":{},"ISSN":["0971-6203","1998-3913"],"issn-type":[{"value":"0971-6203","type":"print"},{"value":"1998-3913","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-06-21","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}