1Gynecological Onclolgy Center, Chongqing University Cancer Hospital, Chongqing 400030, China; 2Bioengineering College of Chongqing University, Chongqing 400030, China; 3Radiation Oncology Center, Chongqing University Affiliated Cancer Hospital, Chongqing 400030, China
AbstractObjective To evaluate the difference of dosimetry between three-dimensional and two-dimensional plans based on CT images of occult perforation in brachytherapy of cervical cancer, aiming to provide clinical reference. Methods A total of 817 patients with cervical cancer received simple intrauterine (intrauterine tandem plus vaginal colpostats) three-dimensional brachytherapy in Chongqing University Cancer Hospital from January 2019 to December 2020 were retrospectively reviewed. Among them, 16 patients had occul uterine perforation. Based on Oncentra Brachy Therapy plan system, the single prescription dose was 6Gy. Three-dimensional (3D group) and two-dimensional (2D group) plans were designed on the perforated CT images The target volume, conformal index (CI), conformal index coformity index (COIN) and organs-at-risk (OAR) D2cm3 parameters were used to assess the plans between two groups. Results The incidence of pccult uterine perforation was 1.96%(16/817) during brachytherapy for cervical cancer. The volume of prescription dose curve in the 3D group was(40.74±14.98) cm3, significantly smaller compared with (91.46±19.71) cm3 in the 2D group (P<0.05), whereas the volume of the high-risk clinical target area wrapped by prescription dose curve did not significantly differ between two groups (P>0.05). The CI and COIN in the 3D group were 0.79±0.10 and 0.72±0.96, significantly higher compared with 0.38±0.09 and 0.37±0.18 in the 2D group (both P<0.05). The D2cm3 of bladder, rectum, sigmoid colon, small intestine in the 3D group were (306.06±77.57) cGy,(252.27±72.60) cGy,(127.25±62.84) cGy and (228.79±94.90) cGy, significantly lower than (548.03±164.21) cGy,(411.16±118.74) cGy,(227.45±94.48) cGy and (450.95±157.96) cGy in the 2D group (all P<0.05). Conclusions Application of image guidance in brachytherapy of cervical cancer is helpful to detect occult uterine perforation. When occult uterine perforation occurs, the use of three-dimensional plan can basically meet the clinical needs, which is significantly better than the two-dimensional plan.
Fund:Chongqing Science and Health Joint Medical Research Project-Surface Project (2021MHZXM172);Chongqing Science and Health Joint Medical Research Project-Key Project (2019ZDXM031)
About author:: Zhao Xiujuan and Wu Haiyan contributed equally to this article
Cite this article:
Zhao Xiujuan,Wu Haiyan,Zhong Mingsong et al. Study of occult uterine perforation in brachytherapy of cervical cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(7): 682-687.
Zhao Xiujuan,Wu Haiyan,Zhong Mingsong et al. Study of occult uterine perforation in brachytherapy of cervical cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(7): 682-687.
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