Abstract：Objective To examine the dosimetric advantages of three-dimensional (3D) computed tomography (CT)-guided interstitial brachytherapy (BT) for target volume and surrounding normal tissue in patients with locally advanced cervical cancer,and to provide a simple and effective clinical treatment approach.Methods A total of 52 patients who had poor tumor response to external beam radiotherapy (EBRT) with a residual tumor greater than 5 cm at the time of BT were included. The patients were treated by 3D CT-guided interstitial BT using a “hybrid” applicator comprised of uterine tandem and free metal needles. The high-risk clinical target volume (HR-CTV),intermediate-risk clinical target volume (IR-CTV),and organs at risk (OAR) were contoured. The total dose,including external beam radiotherapy and high dose-rate BT,was biologically normalized to conventional 2 Gy fractions (EQD2).D90 and D100 for both HR-CTV and IR-CTV,and D2 cc for the bladder,rectum,and sigmoid were analyzed. Results The mean D90 value for HR-CTV was 88.4±3.5 Gy. The D2 cc for the bladder,rectum,and sigmoid were 81.1±5.6,65.7±5.1,and 63.1±5.4 Gy,respectively.D2 cc ≤90 Gy for the bladder and D2 cc ≤70 Gy for the sigmoid wereobserved in all the patients.D2 cc ≤70 Gy for the rectum was observed in 89% of patients. Conclusions 3DCT-guided interstitial BT has a significant dosimetric advantage for target volume accompanied by few minor complications,and thereby may be clinically feasible for treating locally advanced cervical cancer. However,its long-term efficacy and possible toxicities will require further clinical observation.
. CT-guided interstitial brachytherapy for locally advanced cervical cancer:introduction of the technique and report of dosimetry[J]. Chinese Journal of Radiation Oncology, 2017, 26(5): 550-554.
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