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Most commercially available treatment planning systems for brachytherapyoperate based on physical dose and do not incorporate fractionation ortissue-specific response. The purpose of this study is to investigate thepotential for hypofractionation in HDR brachytherapy, thereby reducing thenumber of implants required. A new treatment planning algorithm was built inorder to optimize based on tissue and fractionation specific parameters.Different fractionation schemes were considered for 6 patients, and plans werecreated using the new algorithm. A baseline fractionation scheme consisting of5 fractions was compared to hypofractionated plans of 1 to 4 fractions. Theeffectiveness of each plan was evaluated using radiobiological criteria takenfrom GEC-ESTRO guidelines. The results of this study indicate that anoptimization algorithm based on biological parameters has similar functionalityto traditional planning methods with the additional ability to account forfractionation effects. Using this algorithm, it was shown that plans consistingof 3 and 4 fractions have comparable target coverage with equivalent normaltissue exposure. In some specific cases, further fractionation may presentacceptable target coverage as well.

A new radiobiology-based HDR brachytherapy treatment planning algorithm used to investigate the potential for hypofractionation in cervical cancer