TY - JOUR
T1 - CT-based image-guided brachytherapy in uterine cervical cancer
T2 - Effect of tumor dose and volume on local control
AU - Uezono, Haruka
AU - Tsujino, Kayoko
AU - Inoue, Yuko
AU - Kajihara, Akifumi
AU - Marudai, Mitsuru
AU - Bessho, Ryosuke
AU - Sekii, Shuhei
AU - Kubota, Hikaru
AU - Yamaguchi, Satoshi
AU - Ota, Yosuke
N1 - Publisher Copyright:
© 2022 American Brachytherapy Society
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Background and Purpose: To determine the optimal primary tumor dose for cervical cancer treatment using computed tomography (CT)-based image-guided brachytherapy (IGBT). Materials and Methods: We retrospectively reviewed 171 patients with cervical cancer who underwent both external beam radiation therapy (EBRT) and IGBT between May 2015 and December 2019. Majority of EBRT plan included central shielding technique. CT-based IGBT was performed weekly a median of three times. Magnetic resonance imaging preceded the first and third session of IGBT for target delineation. Results: The median age of the patients was 64 years (range: 30–91 years). The median follow-up time for living patients was 43 months (range: 6–76 months). The 3-year local control rates according to the International Federation of Gynecology and Obstetrics (FIGO, 2008) stages were 89%, 100%, 92%, 89%, 78%, and 100% for stages IB, IIA, IIB, IIIA, IIIB, and IVA, respectively. The median EBRT dose to the central pelvis and parametrium/pelvic wall was 41.4 Gy and 50.4 Gy, respectively. Patients who received a cumulative 2 Gy equivalent dose (EQD2) (α/β = 10 Gy) of high-risk clinical target volume (HR CTV) D90% ≥ 75 Gy achieved a long-term local control rate of 93%, compared with 80% in those who received <75 Gy (p = 0.02). Conclusion: This is one of the largest CT-based IGBT series examining the treatment of cervical cancer based on the tumor dose-volume relationship. An HR CTV D90% ≥75 Gy was significantly associated with favorable local control in this study.
AB - Background and Purpose: To determine the optimal primary tumor dose for cervical cancer treatment using computed tomography (CT)-based image-guided brachytherapy (IGBT). Materials and Methods: We retrospectively reviewed 171 patients with cervical cancer who underwent both external beam radiation therapy (EBRT) and IGBT between May 2015 and December 2019. Majority of EBRT plan included central shielding technique. CT-based IGBT was performed weekly a median of three times. Magnetic resonance imaging preceded the first and third session of IGBT for target delineation. Results: The median age of the patients was 64 years (range: 30–91 years). The median follow-up time for living patients was 43 months (range: 6–76 months). The 3-year local control rates according to the International Federation of Gynecology and Obstetrics (FIGO, 2008) stages were 89%, 100%, 92%, 89%, 78%, and 100% for stages IB, IIA, IIB, IIIA, IIIB, and IVA, respectively. The median EBRT dose to the central pelvis and parametrium/pelvic wall was 41.4 Gy and 50.4 Gy, respectively. Patients who received a cumulative 2 Gy equivalent dose (EQD2) (α/β = 10 Gy) of high-risk clinical target volume (HR CTV) D90% ≥ 75 Gy achieved a long-term local control rate of 93%, compared with 80% in those who received <75 Gy (p = 0.02). Conclusion: This is one of the largest CT-based IGBT series examining the treatment of cervical cancer based on the tumor dose-volume relationship. An HR CTV D90% ≥75 Gy was significantly associated with favorable local control in this study.
KW - Brachytherapy
KW - Cervical cancer
KW - Computed tomography
KW - Image-guided
UR - https://www.scopus.com/pages/publications/85138758920
UR - https://www.scopus.com/pages/publications/85138758920#tab=citedBy
U2 - 10.1016/j.brachy.2022.08.012
DO - 10.1016/j.brachy.2022.08.012
M3 - Article
C2 - 36155168
AN - SCOPUS:85138758920
SN - 1538-4721
VL - 21
SP - 814
EP - 822
JO - Brachytherapy
JF - Brachytherapy
IS - 6
ER -
