Abstract：Objective To compare the dosimetry and efficacy of intracavitary brachytherapy (ICBT) and intracavitary/interstitial brachytherapy (IC+ISBT) based on CT image guidance in the treatment of stage ⅢB cervical cancer. Methods Clinical data of 93 patients with stage ⅢB cervical cancer treated in Department of Radiotherapy of Jilin Cancer Hospital from June 2014 to February 2017 were analyzed retrospectively. According to the results ofGynecological examination and pelvic MRI before brachytherapy, confirming the size of residual tumor and the degree of parauterine infiltration, all patients were divided into the ICBT and IC+ISBT groups. The D90%, D100%, V100% and D2cm3 of bladder and rectum were compared, and the short-term and long-term efficacy was observed between two groups. Results The median follow-up time was 60 months. The 5-year local control rate, distant metastasis-free survival rate and overall survival rate of all patients were 83%, 71% and 68%, respectively. Compared with the ICBT group, HR-CTV D90% in the IC+ISBT group was all more than 85Gy, while there was no significant difference between two groups (P=0.188). The D2cm3 of bladder and rectum in the IC+ISBT group was significantly decreased by 7Gy and 8Gy (both P<0.01), and the distant metastasis-free survival rate was significantly improved (P=0.009). The 5-year local control rate in the HR-CTV volume>60cm3 in the IC+ISBT group was significantly higher than that in the IC group (P=0.029). Conclusion For patients with ⅢB cervical cancer, IC+ISBT can not only ensure target coverage, but also significantly reduce the incidence of distant metastasis and the dose of organs at risk, and significantly improve the local control rate of large tumors.
Xiu Yuting,Meng Fanxu,Wang Zhuo et al. Analysis of dosimetry and clinical efficacy of intracavitary/interstitial brachytherapy in ⅢB cervical cancer[J]. Chinese Journal of Radiation Oncology, 2022, 31(6): 539-543.
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