16 Cervix Carcinoma

328 Cervix Cancer

Fig 14.12: IGR method

Fig 14.12.A: Patient with locally advanced disease with a mould applicator. Dose distribution showing different isodose lines. Representation of the Surface of the large pear (60 Gy Reference Volume) and one Coronal Plane. Doses for different reference points including point A are given. 60 Gy Reference Volume is 400 cm 3 Anterior-posterior and lateral radiographs showing the applicator in place and ICRU-reference points in bladder (balloon) and rectum, at the pelvic wall and in the lymphatic trapezoid for dose calculation and treatment planning (compare Fig 14.3). Maximum dose for the rectum is 20 Gy, other dose points indicate a dose of 10-12 Gy. Dose for the sigmoid point is 13.9 Gy Dose at the Bladder ICRU point is 26 Gy, at point AlG dose is 31.9 Gy Pelvic Wall Point Doses are right 9.7 Gy and left 7.4 Gy Dose at Point A is 37.4 Gy and at Point B 9.2 Gy. Dose from external beam therapy was 45 Gy, dose from intracavitary brachytherapy 15 Gy specified at the 60 Gy Reference Volume.