A surveillance study of intensity-modulated radiation therapy for postoperative cervical cancer in Japan.

A surveillance study of intensity-modulated radiation therapy for postoperative cervical cancer in Japan.
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DOI:
10.1093/jrr/rrv020
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发表时间:
2015-07
影响因子:
2
通讯作者:
Itami J
Itami J
中科院分区:
医学4区
文献类型:
--
作者:
Murakami N;Okamoto H;Isohashi F;Murofushi K;Ohno T;Yoshida D;Saito M;Inaba K;Ito Y;Toita T;Itami J

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调强放射治疗(IMRT)最近被引入到妇科恶性肿瘤领域,然而,其价值尚未得到验证。一项临床试验正在准备中,以调查调强放射治疗宫颈癌术后的有效性和可行性。本研究的目的是进行宫颈癌术后调强放疗的监测研究。一份关于进行调强放射治疗的精确方法的调查问卷被发送到六个已经引入调强放射治疗宫颈癌术后的机构,并对数据进行了分析。一半的机构使用静态调强放射治疗,其他机构使用调容弧形治疗(VMAT)。大多数机构使用身体固定装置进行患者固定。大多数机构指导患者在接受计划CT或日常治疗前充盈膀胱。一家机构插入金属标记物,另一家机构使用放射性造影剂浸泡的纱布来可视化阴道断端,而其他机构则未使用任何方法进行阴道断端可视化。大多数机构根据日本临床肿瘤学组或放射治疗肿瘤学组指南定义临床靶体积。只有一家机构使用基于PTV 95%的处方剂量(D95),而其余机构使用平均剂量(Dmean)。来自六家领先机构的宝贵信息将用于未来的前瞻性临床试验。
Intensity-modulated radiation therapy (IMRT) was recently introduced to the field of gynecologic malignancies; however, its value is not yet validated. A clinical trial is in preparation to investigate the efficacy and feasibility of IMRT for postoperative cervical cancer. The object of this study was to perform a surveillance study of IMRT for post-operative cervical cancer. A questionnaire regarding the precise methods of conducting IMRT was sent to six institutions that had already introduced IMRT for post-operative cervical cancer, and the data were analyzed. Half of the institutions used static IMRT and the others used volumetric-modulated arc therapy (VMAT). Most institutions used body-immobilizing devices for patient fixation. Most institutions instructed patients to fill their bladder before undergoing planning CT or daily treatment. While one institution inserted metallic markers and another one used radio-contrast–soaked gauze to visualize the vaginal cuff, the other institutions used nothing for vaginal cuff visualization. Most institutions defined the clinical target volumes according to the Japan Clinical Oncology Group or the Radiation Therapy Oncology Group guidelines. Only one institution used a prescribed dose based on 95% of the PTV (D95), while the rest used the mean dose (Dmean). This valuable information from six leading institutions will be utilized in a future prospective clinical trial.
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