宫颈癌三维腔内放疗同步体外施源器引导下IMRT剂量学研究

doi:10.3760/cma.j.issn.1004-4221.2017.12.014

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Abstract

Objective To evaluate the dosimetric feasibility of three-dimensional (3D) intracavitary brachytherapy in combination with applicator-guided intensity-modulated radiation therapy (IMRT) boost for patients with locally advanced cervical cancer who have unfavorable topography following external beam irradiation. Methods A total of 7 patients with locally advanced cervical cancer who had unfavorable topography following external beam irradiation were included. Two plans were generated for brachytherapy using Oncentra 4.3 treatment planning system:3D intracavitary brachytherapy and 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost. To further evaluate cumulative doses to organs at risk (OAR) in the four fractions of combined plans, two methods were used:simple dose-volume histograms (DVH) parameter addition and deformable image registration (DIR)-based DVH accumulation. The D90, V100, and conformity index (CI) were evaluated. The paired t-test or Wi1coxon signed rank test was used for statistical analysis. Results Compared with the 3D plan, the combined plan yielded higher D90, V100, and CI (P=0.000), but showed no significant difference in D2cc of the rectum, sigmoid colon, and bladder (P>0.05). There were also no significant differences in D2cc of the rectum, sigmoid colon, and bladder calculated by the two methods for calculating OAR cumulative doses, simple DVH parameter addition and DIR-based DVH accumulation (P>0.05). Conclusions For patients with cervical cancer who have unfavorable topography following external beam irradiation, 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost can improve target coverage and CI, without increasing OAR doses. DIR-based DVH accumulation and simple DVH parameter addition may be both acceptable for assessing OAR cumulative doses.

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	Articles by authors
	Zhao Xinyu
	Zhao Jing
	Gu Fei
	Ji Tianlong
	Xia bing
	Zhang Shuo
	Yao Lei
	Li Guang

Key words： Cervical neoplasms/three-dimensional brachytherapy Cervical neoplasms/intensity-modulated radiotherapy Dosimetry

Received: 21 December 2016

Corresponding Authors: Li Guang,Email:13804058616@163.com

Cite this article:

Zhao Xinyu,Zhao Jing,Gu Fei et al. A dosimetric study of 3D intracavitary brachytherapy in combination with applicator-guided IMRT boost for cervical cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(12): 1421-1425.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.12.014 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I12/1421

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