A comparative study of positron emission tomography-computed tomography and computed tomography image-guided radiotherapy for cervical cancer with retroperitoneal node metastasis
An Jusheng,Xu Yingjie,Du Xiaomeng,Zhang Wenjie,Dai Jianrong,Zheng Rong,Huang Manni,Wu Lingying
Department of Gynecologic Oncology (An JSH,Du XM,Huang MN,Wu LY),Department of Radiation Oncology (Xu YJ,Dai JR),Department of PET-CT (Zhang WJ,Zheng R,Wu N),National Cancer Center/Cancer Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 100021,China
Abstract：Objective To evaluate the feasibility of using positron emission tomography-computed tomography (PET-CT) to guide lesion localization and radiotherapy planning for stage ⅡB-IVA cervical cancer with retroperitoneal node metastasis. Methods Before treatment, PET-CT was used for staging and lesion localization. Three-dimensional radiotherapy (3DRT) plans with boost doses for metastatic lymph nodes were made based on the fused PET-CT images. The obtained plans were compared with CT image-guided plans within the same period. Comparison was made by paired t test or non-parametric test. Results The PET-CT plans had significantly larger GTVnd, pGTVnd, CTV, and PTV than the CT plans (P=0.012, 0.010, 0.018, 0.018). There were no significant differences in V40, V50, or D1 cm3 for the small intestine between the two plans (P=0.744, 0.588, 0.423). The PET-CT plans had significantly lower V20, V30, and Dmean for the small intestine than the CT plans (68.1% vs. 74.5%, P=0.020;36.1% vs. 39.6%, P=0.016;2 546.1 vs. 2 761.4 Gy, P=0.036). Moreover, the PET-CT plans had significantly larger V20 and Dmean for the kidney than the CT plans (9.4% vs. 5.7%, P=0.006;877.0 vs. 733.8 Gy, P=0.005). There were no significant differences in V30 and V40 for the kidney or Dmean for the rectum, bladder, colon, pelvic bone, bone marrow, and femoral head between the two plans (P=0.089, 0.341, 0.406, 0.107, 0.178, 0.397, 0.285, 0.743). Conclusions It is feasible to use fused PET-CT images to guide external 3DRT plans, which can accurately localize the metastatic lymph nodes and elevate the radiation dose. However, the protection of the small intestine and kidney should be taken into account.
. A comparative study of positron emission tomography-computed tomography and computed tomography image-guided radiotherapy for cervical cancer with retroperitoneal node metastasis[J]. Chinese Journal of Radiation Oncology, 2016, 25(9): 944-947.
2016, Vol. 25 
