Radiobiological Evaluation of Stage III Cervical Cancer Radiotherapy Using EUD-Based TCP and NTCP in 3DCRT
DOI:
https://doi.org/10.25077/jif.18.2.199-209.2026Keywords:
Cervical Cancer, Radiotherapy, Homogeneity Index , Conformity Index, Equivalent Uniform DoseAbstract
This study evaluated the dosimetric and radiobiological parameters in 24 patients with Stage III cervical cancer treated with Three-Dimensional Conformal Radiation Therapy (3DCRT) at Universitas Andalas Hospital, using an Indonesian clinical dataset for context-specific radiobiological evaluation. Physical dose quality was assessed using the Homogeneity Index (HI) and Conformity Index (CI). Biological effectiveness was evaluated using Niemierko’s Equivalent Uniform Dose (EUD) model to determine Tumor Control Probability (TCP) and Normal Tissue Complication Probability (NTCP). Dose-volume histogram (DVH) data were extracted from the Eclipse TPS and processed via Python. Physical planning demonstrated acceptable conformity (CI = 0.9695 ± 0.0084) and homogeneity (HI = 0.0739 ± 0.0129). Mean TCP for the external beam radiotherapy phase (50 Gy in 25 fractions) was 41.36% ± 0.31%, representing moderate biological control prior to brachytherapy. Organs at risk exhibited low toxicity for the rectum (NTCP = 0.40% ± 0.18%) and bowel (NTCP = 2.06% ± 3.00%). Conversely, the bladder showed the highest complication risk (NTCP = 83.16% ± 26.78%, EUD = 93.57 ± 9.99 Gy), frequently exceeding tolerance limits due to anatomical proximity and volume variability. 3DCRT yields satisfactory physical coverage and rectal/bowel sparing, but requires standardized bladder protocols to minimize toxicity.
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