Preliminary study on relationship between DVH parameters and late side effects of rectum in external-beam radiotherapy combined with CT-based brachytherapy for locally advanced cervical cancer
An Jusheng*, Huang Manni, Xu Yingjie, Xiong Suiyang, Wu Lingying, Dai Jianrong
*Department of Gynecologic Oncology, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China
Abstract：Objective To investigate the relationship between dose-volume histogram (DVH) parameters and the late side effects (LSE) of the rectum in external-beam radiotherapy combined with computed tomography (CT)-based brachytherapy for locally advanced cervical cancer. Methods From 2008 to 2011, 18 patients with stage IIB-IIIB cervical cancer received external-beam radiotherapy and CT-based brachytherapy. The DVH parameters of high-risk clinical target volume (HR CTV) D90, point A dose, and D1 cm3 and D2 cm3 of the rectum and bladder were calculated by Oncentra HDR treatment planning system. Survival outcomes were followed up and rectal LSE were evaluated by RTOG/EORTC grades. Results The point A dose and HR CTV D90 were (93.0±5.5) Gy and (73.6±11.9) Gy, respectively. The median follow-up was 26 months. No recurrence was found during follow-up. Eight patients had mild and moderate rectal LSE, and their rectum D2 cm3 and D1 cm3 were significantly higher than those of patients without mild and moderate rectal LSE (D2 cm3 :(87.4±3.8) Gy vs. (75.8±7.4) Gy, P=0.004;D1 cm3 :(96.4±6.6) Gy vs. (80.5±7.1) Gy, P=0.001). Conclusions HR CTV D90 in CT-based brachytherapy for locally advanced cervical cancer might be lower than that in the MRI-based plan. Rectum D2 cm3 is recommended to be less than 75 Gy.
. Preliminary study on relationship between DVH parameters and late side effects of rectum in external-beam radiotherapy combined with CT-based brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2014, 23(5): 373-376.
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