In-room computed tomography-based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study.
In-room computed tomography-based brachytherapy for uterine cervical cancer: results of a 5-year retrospective study.
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DOI：
10.1093/jrr/rrw121
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发表时间：
2017-07-01
影响因子：
2
通讯作者：
Nakano T
中科院分区：
文献类型：
--
作者：
Ohno T;Noda SE;Okonogi N;Murata K;Shibuya K;Kiyohara H;Tamaki T;Ando K;Oike T;Ohkubo Y;Wakatsuki M;Saitoh JI;Nakano T
在此，我们研究了宫颈癌患者接受基于室内计算机断层扫描的近距离放射治疗的长期临床结局。回顾性分析了2008年10月至2011年5月期间接受3D高剂量率近距离放射治疗和适形放射治疗的80例IB 1-IVA期宫颈癌患者。每例患者均在20-40戈伊后行外照射（50戈伊）加中心屏蔽。年龄≤75岁的晚期患者同时接受以顺铂为基础的化疗。近距离放射治疗分为4个部分，每周6戈伊。进行了室内计算机断层扫描成像和施源器插入，以制定治疗计划。参考诊断时体格检查、诊断时和第一次近距离放射治疗前的近距离放射治疗和磁共振成像的信息，以勾画高风险临床靶体积。中位随访时间为60个月。5年局部控制率、盆腔无进展生存率和总生存率分别为94%、90%和86%。在I期、II期和III-IVA期患者之间未观察到5年局部控制率的显著差异。相反，在II期和III-IVA期患者之间观察到5年总生存率的显著差异（97% vs 72%; P = 0.006）。1例患者发生3级晚期膀胱毒性。直肠或膀胱中未报告其他3级或以上晚期毒性。总之，无论临床分期如何，直肠或膀胱的局部控制率都很高，晚期毒性最小。
Herein, we investigate the long-term clinical outcomes for cervical cancer patients treated with in-room computed tomography–based brachytherapy. Eighty patients with Stage IB1–IVA cervical cancer, who had undergone treatment with combined 3D high-dose rate brachytherapy and conformal radiotherapy between October 2008 and May 2011, were retrospectively analyzed. External beam radiotherapy (50 Gy) with central shielding after 20–40 Gy was performed for each patient. Cisplatin-based chemotherapy was administered concurrently to advanced-stage patients aged ≤75 years. Brachytherapy was delivered in four fractions of 6 Gy per week. In-room computed tomography imaging with applicator insertion was performed for treatment planning. Information from physical examinations at diagnosis, and brachytherapy and magnetic resonance imaging at diagnosis and just before the first brachytherapy session, were referred to for contouring of the high-risk clinical target volume. The median follow-up duration was 60 months. The 5-year local control, pelvic progression-free survival and overall survival rates were 94%, 90% and 86%, respectively. No significant differences in 5-year local control rates were observed between Stage I, Stage II and Stage III–IVA patients. Conversely, a significant difference in the 5-year overall survival rate was observed between Stage II and III–IVA patients (97% vs 72%; P = 0.006). One patient developed Grade 3 late bladder toxicity. No other Grade 3 or higher late toxicities were reported in the rectum or bladder. In conclusion, excellent local control rates were achieved with minimal late toxicities in the rectum or bladder, irrespective of clinical stage.
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影响因子：
2
作者：
Ohno T;Toita T;Tsujino K;Uchida N;Hatano K;Nishimura T;Ishikura S
通讯作者：
Ishikura S
影响因子：
2
作者：
Nakagawa A;Ohno T;Noda SE;Kubo N;Kuwako K;Saitoh J;Nakano T
通讯作者：
Nakano T
影响因子：
3.1
作者：
Lindegaard, Jacob Christian;Fokdal, Lars Ulrik;Tanderup, Kari
通讯作者：
Tanderup, Kari
影响因子：
5.7
作者：
Sturdza, Alina;Poetter, Richard;Lindegaard, Jacob Christian
通讯作者：
Lindegaard, Jacob Christian
影响因子：
5.7
作者：
Ribeiro, Ivone;Janssen, Hilde;Van Limbergen, Erik
通讯作者：
Van Limbergen, Erik