局部晚期宫颈癌三维适形近距离治疗中ICRU参考点剂量与OAR体积剂量参数的关系研究

doi:10.3760/cma.j.issn.1004-4221.2016.05.014

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Abstract Objective To investigate the correlation between ICRU reference point dose and dose-volume parameters of organs at risk (OARs) under different bladder and rectal filling status in three-dimensional conformal brachytherapy for locally advanced cervical cancer. Methods A total of 31 patients who received magnetic resonance imaging-guided three-dimensional conformal brachytherapy for cervical cancer in 96 fractions were enrolled. The ICRU rectal and bladder reference points were determined in the treatment planning system, and the doses at these points were recorded and compared with the dose-volume parameters of the rectum and bladder. The paired t-test was used to analyze the differences between them. Results Bladder D_ICRU was lower than bladder D_{0.1 cm³} and D_{1 cm³}(P=0.000 and 0.000), higher than bladder D_{5 cm³} and D_{10 cm³}(P=0.000 and 0.000), and similar to bladder D_{2 cm³}(P=0.345). Under the bladder filling status, bladder D_ICRU was lower than D_{2 cm³}. Rectal D_ICRU was lower than rectal D_{0.1 cm³} and D_{1 cm³}(P=0.000 and 0.002), higher than rectal D_{5 cm³} and D_{10 cm³}(P=0.000 and 0.000), and similar to rectal D_{2 cm³}(P=0.058). The ICRU bladder and rectal reference point doses were positively correlated with corresponding D_{2 cm³}. In the case of bladder volume ≥200 cm³, the ICRU bladder reference point dose underestimated bladder D_{2 cm³}. In the case of rectal volume ≥37 cm³, the ICRU rectal reference point dose overestimated rectal D_{2 cm³}. Conclusions In three-dimensional conformal brachytherapy, it is generally safe to use D_{2 cm³} as an index to evaluate OARs, but when the bladder or rectum is in an empty status, the ICRU bladder or rectal reference point doses should be considered.

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	Articles by authors
	Zhao Hongfu
	Han Dongmei
	Cheng Guanghui
	Shi Dan
	Zhu Yonggang
	Zhao Zhipeng
	Ge Yuxin

Key words： Cervical neoplasms/bractherapy Bractherapy,three-dimensional conformal Dosimetry

Received: 08 December 2015

Corresponding Authors: Cheng Guanghui,Email:chengguanghuifl@163.com

Cite this article:

Zhao Hongfu,Han Dongmei,Cheng Guanghui et al. Correlation between ICRU reference point dose and dose-volume parameters of organs at risk in three-dimensional conformal brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 483-487.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2016.05.014 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2016/V25/I5/483

[1]International Commission on Radiation Units and Measurements. ICRU Report 38:dose and volume specification for reporting intracavitary therapy in gynecology. International commission on radiation units and measurements[M].Bethesda:ICRU,1985.
[2]Haie-Meder C,Ptter R,Van Limbergen E,et al. Recommendations from gynaecological (GYN) GEC ESTRO working group☆(I):concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV[J].Radiother Oncol,2005,74(3):235-245.DOI:10.1016/j.radonc.2004.12.015.
[3]Ptter R,Haie-Meder C,Van Limbergen E,et al. Recommendations from gynaecological (GYN) GEC ESTRO working group (Ⅱ):concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy-3D dose volume parameters and aspects of 3D imaged-based anatomy,radiation physics,radiobiology[J].Radiother Oncol,2006,78(1):67-77.DOI:10.1016/j.radonc.2005.11.014.
[4]Hassouna AH,Bahadur YA,Constantinescu C,et al. In vivo diode dosimetry vs.computerized tomography and digitally reconstructed radiographs for critical organ dose calculation in high-dose-rate brachytherapy of cervical cancer[J].Brachytherapy,2011,10(6):498-502.DOI:10.1016/j.brachy.2011.03.004.
[5]Mazeron R,Gilmore J,Champoudry J,et al. Volumetric evaluation of an alternative bladder point in brachytherapy for locally advanced cervical cancer[J].Strahlenther Onkol,2014,190(1):41-47.DOI:10.1007%2Fs00066-013-0463-6.
[6]Lim J,Durbin-Johnson B,Valicenti R,et al. The impact of body mass index on rectal dose in locally advanced cervical cancer treated with high-dose-rate brachytherapy[J].Brachytherapy,2013,12(6):550-554.DOI:10.1016/j.brachy.2013.04.006.
[7]Mazeron R,Kom LK,del Campo ER,et al. Comparison between the ICRU rectal point and modern volumetric parameters in brachytherapy for locally advanced cervical cancer[J].Cancer/Radiothér,2014,18(3):177-182.DOI:10.1016/j.canrad.2014.03.002.
[8]Wachter-Gerstner N,Wachter S,Reinstadler E,et al. Bladder and rectum dose defined from MRI based treatment planning for cervix cancer brachytherapy:comparison of dose-volume histograms for organ contours and organ wall,comparison with ICRU rectum and bladder reference point[J].Radiother Oncol,2003,68(3):269-276.DOI:10.1016/S0167-8140(03)00189-0.
[9]Fellner C,Ptter R,Knocke TH,et al. Comparison of radiography-and computed tomography-based treatment planning in cervix cancer in brachytherapy with specific attention to some quality assurance aspects[J].Radiother Oncol,2001,58(1):53-62.DOI:10.1016/S0167-8140(00)00282-6.
[10]Sresty NM,Ramanjappa T,Rao CR,et al. A comparative study of two reconstructive methods and different recommendations in intracavitary brachytherapy[J].J Contemp Brachytherapy,2010,2(4):171-175.DOI:10.5114/jcb.2010.19498.
[11]Wachter-Gerstner N,Wachter S,Reinstadler E,et al. The impact of sectional imaging on dose escalation in endocavitary HDR-brachytherapy of cervical cancer:results of a prospective comparative trial[J].Radiother Oncol,2003,68(1):51-59.DOI:10.1016/S0167-8140(03)00083-5.
[12]Shah S,Sharma R,Yaparpalvi R,et al. ICRU Points significantly underestimate the bladder and rectal dose delivered by high-dose-rate brachytherapy for cervical cancer[J].Brachytherapy,2006,5(2):100-101.DOI:10.1016/j.brachy.2006.03.076.
[13]施丹,赵志鹏,何明远,等.宫颈癌三维适形近距离治疗膀胱体积变化对正常组织受量影响[J].中华放射肿瘤学杂志,2015,24(2):159-162.DOI:10.3760/cma.j.issn.1004-4221.2015.02.013.
Shi D,Zhao ZP,He MY,et al. Effect of bladder volume change on normal tissue doses in 3D conformal brachytherapy for cervical cancer[J].Chin J Radiat Oncol,2015,24(2):159-162.DOI:10.3760/cma.j.issn.1004-4221.2015.02.013.
[14]Mazeron R,Castelnau-Marchand P,Dumas I,et al. Impact of treatment time and dose escalation on local control in locally advanced cervical cancer treated by chemoradiation and image-guided pulsed-dose rate adaptive brachytherapy[J].Radiother Oncol, 2015,114(2):257-263.DOI:10.1016/j.radonc.2014.11.045.