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Dosimetry and short term effect comparison of CT-guided interstitial brachytherapy and intracavitary brachytherapy for locally advanced cervical cancer
Liu Zhongshan, Guo Jie, Zhao Yangzhi, Lin Xia, Ren Xiaojun, Wang Hongyong, Qiu Ling, LiYunfeng, Wang Tieiun
Department of Radiation Oncology,Second Affiliated Hospital of Jilin University,Changchun 130041,China (Liu ZS,Guo J,Lin X,Ren XJ,Wang HY,Qiu L,Li YF,Wang TJ);
Cancer Center,First Affiliated Hospital of Jilin University,Changchun 130021,China (Zhao YZ)
Objective To discuss the dosimetric advantage of computed tomography-guided interstitial brachytherapy compared with the conventional intracavitary brachytherapy for locally advanced cervical cancer,offering a more advantageous clinical treatment approach. Methods Twenty-eight locally advanced cervical cancer patients with bulky tumors (tumor size>5 cm) after external beam radiotherapy received computed tomography-guided interstitial brachytherapy. Dosimetric outcomes of the current study,including the total dose (external beam radiotherapy+ brachytherapy) D90 for the HR-CTV and D2cc for the bladder,rectum,and sigmoid,were compared with a former patient group consisting of 30 patients who received the conventional intracavitary brachytherapy (uterine tandem+ ovoid pairs). Results The mean D90 value for HR-CTV in the intracavitary brachytherapy group and interstitial brachytherapy group were (76.9±5.7) and (88.1±3.3) Gy,respectively. The D2cc for the bladder,rectum,and sigmoid in the intracavitary brachytherapy group and interstitial brachytherapy group were (84.7±6.8) Gy,(69.2±4.2) Gy,(67.8±4.5) Gy and (81.8±6.5) Gy,(6.8±4.0) Gy,(64.8±4.1) Gy,respectively.1-year local tumor control rate in the intracavitary brachytherapy group and interstitial brachytherapy group were 59.3% and 85.2%,respectively. Conclusions CT-guided interstitial brachytherapy shows a significant dosimetric advantage compared with the conventional intracavitary brachytherapy,and is,thereby,clinically possible feasible. However,the long term curative effect and toxicity need to be further investigated.
Corresponding Authors:
Wang Tiejun,Email:wangtiejunjlu@163.com
Cite this article:
Liu Zhongshan,Guo Jie,Zhao Yangzhi et al. Dosimetry and short term effect comparison of CT-guided interstitial brachytherapy and intracavitary brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(6): 588-592.
Liu Zhongshan,Guo Jie,Zhao Yangzhi et al. Dosimetry and short term effect comparison of CT-guided interstitial brachytherapy and intracavitary brachytherapy for locally advanced cervical cancer[J]. Chinese Journal of Radiation Oncology, 2018, 27(6): 588-592.
[1] Erickson B,Albano K,Gillin M.CT-guided interstitial implantation of gynecologic malignancies[J].Int J Radiat Oncol Biol Phys,1996,36(3):699-709.DOI:10.1016/S0360-3016(96)00373-2.
[2] Kirisits C,Lang S,Dimopoulos J,et al. The Vienna applicator for combined intracavitary and interstitial brachytherapy of cervical cancer:design,application,treatment planning,and dosimetric results[J].Int J Radiat Oncol Biol Phys,2006,65(2):624-630.DOI:10.1016/j.ijrobp.2006.01.036.
[3] Nomden CN,de Leeuw AAC,Moerland MA,et al. Clinical use of the Utrecht applicator for combined intracavitary/interstitial brachytherapy treatment in locally advanced cervical cancer[J].Int J Radiat Oncol Biol Phys,2012,82(4):1424-1430.DOI:10.1016/j.ijrobp.2011.04.044.
[4] 刘忠山,赵杨祉,郭杰,等.CT引导下局部晚期宫颈癌组织间插植近距离治疗剂量学分析[J].中华放射肿瘤学杂志,2017,26(5):550-554.DOI:10.3760/cma.j.issn.1004-4221.2017.05.015.
Liu ZS,Zhao YZ,Guo J,et al. CT-guided interstitial brachytherapy for locally advanced cervical cancer:introduction of the technique and report of dosimetry[J].Chin J Radiat Oncol,2017,26(5):550-554.DOI:10.3760/cma.j.issn.1004-4221.2017.05.015.
[5] Viswanathan AN,Dimopoulos J,Kirisits C,et al. Computed tomography versus magnetic resonance imaging-based contouring in cervical cancer brachytherapy:results of a prospective trial and preliminary guidelines for standardized contours[J].Int J Radiat Oncol Biol Phys,2007,68(2):491-498.DOI:10.1016/j.ijrobp.2006.12.021.
[6] Martinez A,Cox RS,Edmundson GK.A multiple-site perineal applicator (MUPIT) for treatment of prostatic,anorectal,and gynecologic malignancies[J].Int J Radiat Oncol Biol Phys,1984,10(2):297-305.DOI:10.1016/0360-3016(84)90016-6.
[7] Viswanathan AN,Erickson B,Gaffney DK,et al. Comparison and consensus guidelines for delineation of clinical target volume for CT-and MR-based brachytherapy in locally advanced cervical cancer[J].Int J Radiat Oncol Biol Phys,2014,90(2):320-328.DOI:10.1016/j.ijrobp.2014.06.005.
[8] Dimopoulos JC,Lang S,Kirisits C,et al. Dose-volume histogram parameters and local tumor control in magnetic resonance image-guided cervical cancer brachytherapy[J].Int J Radiat Oncol Biol Phys,2009,75(1):56-63.DOI:10.1016/j.ijrobp.2008.10.033.
[9] Dimopoulos JC,Pötter R,Lang S,et al. Dose-effect relationship for local control of cervical cancer by magnetic resonance image-guided brachytherapy[J].Radiother Oncol,2009,93(2):311-315.DOI:10.1016/j.radonc.2009.07.001.
[10] Fokdal L,Tanderup K,Hokland SB,et al. Clinical feasibility of combined intracavitary/interstitial brachytherapy in locally advanced cervical cancer employing MRI with a tandem/ring applicator in situ and virtual preplanning of the interstitial component[J].Radiother Oncol,2013,107(1):63-68.DOI:10.1016/j.radonc.2013.01.010.
[11] Fidarova EF,Berger D,Schüssler S,et al. Dose volume parameter D2cc does not correlate with vaginal side effects in individual patients with cervical cancer treated within a defined treatment protocol with very high brachytherapy doses[J].Radiother Oncol,2010,97(1):76-79.DOI:10.1016/j.radonc.2010.05.005.
[12] Georg P,Lang S,Dimopoulos JCA,et al. Dose-volume histogram parameters and late side effects in magnetic resonance image-guided adaptive cervical cancer brachytherapy[J].Int J Radiat Oncol Biol Phys,2011,79(2):356-362.DOI:10.1016/j.ijrobp.2009.11.002.
2018, Vol. 27 
