Abstract：Objective To analyze the advantages of IPSA combined with increasing cervical center dose in intracavitary and interstitial brachytherapy (IC/IS) for locally advanced cervical cancer. Methods A total of 46stage ⅡB cervical cancer patients with, local lesion size≥5cm after 45Gy/25f external intensity-modulated radiotherapy (IMRT) were recruited. Uterine tandem and needles were implanted, CT was performed, and then HR-CTV, rectum, bladder, sigmoid colon and the area of cervix increased dose (HR-cervix) were delineated, IPSA was used for optimization. According to whether the dose of HR-cervix was increased or not, all patients were divided into IC/IS+HR-cervix group (group A) and IC/IS group (group B). The differences in dosimetric parameters were compared between two groups. Results The relative uterine tandem dwell time was significantly extended in group A (P<0.001). In group B, the V150% and V200% volumes of HR-cervix were increased from 63.94% and 30.80% to 91.54% and 64.06%. The D90% and D100% in group A were significantly lower than those in group B (both P<0.05). There was no statistical difference in organ at risk (OAR) dose. Conclusion IPSA combined with increasing cervical center dose can meet the HR-CTV D90% dose requirement, normal tissue dose limits, and can escalate the doses to local areas of the cervix.
Lin Xia,Wang Tiejun,Wang Jiapeng et al. Application IPSA combined with increasing cervical center dose in intracavitary and interstitial brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(3): 249-252.
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