Abstract：Objective To study the dosimetric differences and short-term efficacy between intracavitary/interstitial brachytherapy (IC/ISBT) and conventional intracavitary brachytherapy (ICBT). Methods Forty-five patients with locally advanced cervical cancer were treated with IC/ISBT and ICBT. Points A (A1,A2), D90%, D100%, organs at risk, and the doses of bladder, colon, rectum and small intestine were calculated and the short-term efficacy was observed between two groups. Results Point A dose was significantly improved in IC/ISBT compared with ICBT (P<0.05). The D90% and D100% in IC/ISBT were significantly higher than those in ICBT (both P<0.05). After brachytherapy, IC/ISBT could obtain a significantly larger increase in target dose when residual tumor diameter was ≥3 cm compared with ICBT (P<0.05). The D2cm3 and D0.1cm3 of bladder, rectum, colon and small intestine did not significantly differ between IC/ISBT and ICBT (all P>0.05). The 1-,3-and 6-month clinical efficacy did not significantly differ between two technologies (all P>0.05). Conclusion During brachytherapy for locally advanced cervical cancer (residual tumor diameter ≥3 cm), IC/ISBT significantly increases the doses of target area and point A without increasing the dose of organs at risk or lowering the short-term clinical efficacy, which has significant dosimetric advantages.
Teng Yun,Zou Lijuan,Zhang Haichen et al. Analysis of dosimetry and clinical efficacy of intracavitary/interstitial brachytherapy in locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2020, 29(11): 959-962.
[1] Tantivatana T, Rongsriyam K. Treatment outcomes of high-dose-rate intracavitary brachytherapy for cervical cancer:a comparison of Ir-192 versus Co-60 sources[J]. Gynecol Oncol, 2018, 29(5):e86. DOI:10.3802/jgo.2018.29.e86. [2] Viswanathan AN, Dimopoulos J, Kirisits C, et al. Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy:results of a prospective trial and preliminary guidelines for standardized contours[J]. Int J Radiat Oncol Biol Phys, 2007, 68(2):491-498. DOI:10.1016/j.ijrobp.2006.12.021. [3] Dimopoulos JC, Kirisits C, Petric F, et al. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer:clinical feasibility and preliminary results[J]. Int J Radiat Oncol Biol Phys, 2006, 66(1):83-90. DOI:10.1016/j.ijrobp.2006.04.041 [4] Pötter R, Haie-Meder C, Van Limbergen E, et al. GEC ESTRO Working Group. Recommendations from gynaecological (GYN) GEC ESTRO working group (Ⅱ):concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology[J]. Radiother Oncol, 2006, 78(1):67-77. DOI:10.1016/j.radonc.2005.11.014. [5] Fokdal L, Tanderup K, Hokland SB, et al. Clinical feasibility of combined intracavitary/interstitial brachytherapy in locally advanced cervical cancer employing MRI with a tandem/ring applicator in situ and virtual preplanning of the interstitial component[J]. Radiother Oncol, 2013, 107(1):63-68. DOI:10.1016/j.radonc.2013.01.010. [6] Nomden CN, de Leeuw AA, Moerland MA, et al. Clinical use of the Utrecht applicator for combined intracavitary/interstitial brachytherapy treatment in locally advanced cervical cancer[J]. Int J Radiat Oncol Biol Phys, 2012, 82(4):1424-1430. DOI:10.1016/j.ijrobp.2011.04.044. [7] 刘忠山,郭杰,赵杨祉,等. 局部晚期宫颈癌CT引导组织间插植BT与腔内BT剂量学与近期疗效比较[J]. 中华放射肿瘤学杂志, 2018, 27(6):588-592. DOI:10.3760/cma.j.issn.1004-4221.2018.06.011. Liu ZS, Guo J, Zhao YZ, et al. Dosimetry and short term effect comparison of CT-guided interstitial brachytherapy and intracavitary brachytherapy for locally advanced cervical cancer[J]. Chin J Radiat Oncol, 2018, 27(6):588-592. DOI:10.3760/cma.j.issn.1004-4221.2018.06.011. [8] Yoshida K, Yamazaki H, Kotsuma T, et al. Simulation analysis of optimized brachytherapy for uterine cervical cancer:can we select the best brachytherapy modality depending on tumor size?[J]. Brachytherapy, 2016, 15(1):57-64. DOI:10.1016/J. BRACHY.2015.10.002. [9] Mohamed S, Kallehauge J, Fokdal L, et al. Parametrial boosting in locally advanced cervical cancer:combined intracavitary/ interstitial brachytherapy vs. intracavitary brachytherapy plus external beam radiotherapy[J]. Brachytherapy, 2015, 14(1):23-28. DOI:10.1016/j.brachy.2014.09.010. [10] 张宁,赵志鹏,程光惠,等. 局部晚期宫颈癌腔内联合组织间插植3D-IGBT的剂量学研究[J] 中华放射肿瘤学杂志, 2015, 24(3):267-270. DOI:10.3760/cma.j.issn.1004-4221.2015.03.009. Zhang N, Zhao ZP, Cheng GH, et al. Dosimetric study of three-dimensional image-quided brachytherapy combined with intracavitary/ interstitial brachytherapy in locally advanced cervical cancer[J]. Chin J Radiat Oncol, 2015, 24(3):267-270. DOI:10.3760/cma.j.issn.1004-4221.2015.03.009. [11] Pötter R,Dimopoulos J, Georg P, et al. Clinical impact of MRI assisted dose volume adaptation and dose escalation in brachytherapy of locally advanced cervix cancer[J]. Radiother Oncol, 2007, 83(2):148-155. DOI:10.1016/j.radonc.2007.04.012.
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