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@ARTICLE{Biltekin:277349,
      author       = {F. Biltekin and C. Bäumer$^*$ and D. A. Khalil$^*$ and M.
                      Gultekin and F. Yildiz and B. Timmermann$^*$},
      title        = {{A}pplicator-guided proton therapy versus multichannel
                      brachytherapy for vaginal vault irradiation.},
      journal      = {Physical and engineering sciences in medicine},
      volume       = {46},
      number       = {3},
      issn         = {2662-4729},
      address      = {[Cham]},
      publisher    = {Springer},
      reportid     = {DKFZ-2023-01355},
      pages        = {1287-1295},
      year         = {2023},
      note         = {2023 Sep;46(3):1287-1295},
      abstract     = {To dosimetrically compare applicator-guided
                      intensity-modulated proton therapy (IMPT) and multichannel
                      brachytherapy (MC-BRT) for vaginal vault irradiation (VVI)
                      with special focus on dose to organs at risk (OARs) and
                      normal tissues. Ten patients with uterine confined
                      endometrial cancer who received adjuvant vaginal cuff
                      brachytherapy were included in this study. For each patient
                      an additional IMPT treatment plan was created using the same
                      computed tomography dataset and contours segmented for
                      MC-BRT plans. Clinical target volume (CTV) was defined as
                      the proximal 3.5 cm of the vagina including the entire
                      thickness of vaginal wall. Planning target volume for IMPT
                      plans was generated from the CTV with an addition isotropic
                      3 mm margin. OARs included rectum, bladder, sigmoid, small
                      bowel and femoral heads. The prescribed dose was 21 Gy in 3
                      fractions. For simplicity, all doses were expressed in Gy
                      and a constant relative biological effectiveness of 1.1 was
                      used for IMPT plans. Plan comparison was performed using
                      dose-volume histogram and treatment planning parameters. A
                      significant improvement of the $D98\%$ coverage for CTV was
                      reached by the applicator-guided IMPT plans (p < 0.01). IMPT
                      also provided a dose reduction in all OARs except for
                      femoral heads due to the lateral beam direction, especially
                      significant reduction of V5Gy, D2cc, D0.1 cc, Dmean, $V95\%$
                      values for the rectum and Dmean, D0.1 cc to bladder,
                      sigmoid, small bowel. Additionally, IMPT plans showed a
                      significant reduction of integral dose to normal tissue with
                      respect to MC-BRT (221.5 cGy.L vs. 653.6 cGy.L, p < 0.01).
                      Applicator-guided IMPT has the potential for improving plan
                      quality in VVI while maintaining the high conformity
                      afforded by the state-of-the-art intracavitary
                      brachytherapy.},
      keywords     = {Brachytherapy (Other) / Endometrium cancer (Other) / Proton
                      therapy (Other) / Vaginal vault irradiation (Other)},
      cin          = {ED01},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:37405636},
      doi          = {10.1007/s13246-023-01297-6},
      url          = {https://inrepo02.dkfz.de/record/277349},
}