Dosimetric analysis of CT-guided salvage interstitial brachytherapy for recurrent cervical cancer
Liu Zhongshan, Guo Jie, Zhao Yangzhi, Lin Xia, Zhang Zhiliang, Wang Hongyong, Li Yunfeng, Ren Xiaojun, Zhang Bingya, Wang Tiejun
Department of Radiation Oncology, the Second Affiliated Hospital of Jilin University, Changchun 130041,China (Liu ZS, Guo J, Lin X, Zhang ZL, Wang HY, Li YF, Ren XJ, Zhang BY, Wang TJ); Cancer Center, the First Affiliated Hospital of Jilin University, Changchun 130021, China (Zhao YZ)
Abstract：Objective To analyze the dosimetric advantages of CT-guided interstitial brachytherapy for recurrent cervical cancer. Methods A total of 16 patients with recurrent cervical cancer after radical surgery and adjuvant external beam radiotherapy received interstitial brachytherapy with CT-guided implantation of metal needles. The high-risk clinical target volume (HR-CTV) was given 36 Gy in 6 fractions. D90 for HR-CTV in the brachytherapy and the cumulative D2 cm3 values for the bladder, rectum, and sigmoid colon in the previous external beam radiotherapy and the brachytherapy were analyzed. Results The mean D90 value for HR-CTV was 52.5±3.3 Gy. The cumulative D2 cm3 values for the bladder, rectum, and sigmoid colon were 85.6±5.8 Gy, 71.6±6.4 Gy, and 69.6±5.9 Gy, respectively. The mean number of metal needles was 6.1±1.5 in each brachytherapy. The actual 1-year overall survival and local control were 81% and 69%, respectively. Conclusions CT-guided interstitial brachytherapy for recurrent cervical cancer shows good dose-volume histogram parameters and few complications, so it may be clinically feasible. However, its long-term clinical efficacy needs further observation.
Liu Zhongshan,Guo Jie,Zhao Yangzhi et al. Dosimetric analysis of CT-guided salvage interstitial brachytherapy for recurrent cervical cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(1): 74-78.
[1] Maggioni A,Roviglione G,Landoni F,et al. Pelvic exenteration:ten-year experience at the European institute of oncology in Milan[J].Gynecol Oncol,2009,114(1):64-68.DOI:10.1016/j.ygyno.2009.03.029 [2] Ng MKY,Leong T,Heriot AG,et al. Once-daily reirradiation for rectal cancer in patients who have received previous pelvic radiotherapy[J].J Med Imaging Radiat Oncol,2013,57(4):512-518.DOI:10.1111/1754-9485.12057 [3] Hille A,Weiss E,Hess CF.Therapeutic outcome and prognostic factors in the radiotherapy of recurrences of cervical carcinoma following surgery[J].Strahlenther Onkol,2003,179(11):742-747.DOI:10.1007/s00066-003-1100-6 [4] Jensen PT,Roed H,Engelholm SA,et al. Pulsed dose rate (PDR) brachytherapy as salvage treatment of locally advanced or recurrent gynecologic cancer[J].Int J Radiat Oncol Biol Phys,1998,42(5):1041-1047.DOI:10.1016/S0360-3016(98)00290-9 [5] Badakh DK,Grover AH.Reirradiation with high-dose-rate remote afterloading brachytherapy implant in patients with locally recurrent or residual cervical carcinoma[J].J Cancer Res Ther,2009,5(1):24-30.DOI:10.4103/0973-1482.48766 [6] Yoshida K,Yamazaki H,Kotsuma T,et al. Treatment results of image-guided high-dose-rate interstitial brachytherapy for pelvic recurrence of uterine cancer[J].Brachytherapy,2015,14(4):440-448.DOI:10.1016/j.brachy.2015.02.195 [7] Greven KM.Interstitial radiation for recurrent cervix or endometrial cancer in the suburethral region[J].Int J Radiat Oncol Biol Phys,1998,41(4):831-834.DOI:10.1016/S0360-3016(98)00119-9 [8] Nag S,Selman AE,Martinez-Monge R,et al. Interstitial re-irradiation as salvage treatment for previously irradiated patients with recurrent gynecologic malignancies[J].J Brachyther Int,1998,14(1):49-57 [9] Viswanathan AN,Beriwal S,De Los Santos JF,et al. American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part Ⅱ:high-dose-rate brachytherapy[J].Brachytherapy,2012,11(1):47-52.DOI:10.1016/j.brachy.2011.07.002 [10] Amsbaugh MJ,Bhatt N,Hunter T,et al. Computed tomography planned interstitial brachytherapy for recurrent gynecologic cancer[J].Brachytherapy,2015,14(5):600-605.DOI:10.1016/j.brachy.2015.05.007 [11] Martinez A,Edmundson GK,Cox RS,et al. Combination of external beam irradiation and multiple-site perineal applicator (MUPIT) for treatment of locally advanced or recurrent prostatic,anorectal,and gynecologic malignancies[J].Int J Radiat Oncol Biol Phys,1985,11(2):391-398.DOI:10.1016/0360-3016(85)90163-4 [12] Fokdal L,Tanderup K,Nielsen SK,et al. Image and laparoscopic guided interstitial brachytherapy for locally advanced primary or recurrent gynaecological cancer using the adaptive GEC ESTRO target concept[J].Radiother Oncol,2011,100(3):473-479.DOI:10.1016/j.radonc.2011.08.016
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