High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy
High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy
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DOI：
10.3349/ymj.2010.51.1.93
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发表时间：
2010-01-01
影响因子：
2.4
通讯作者：
Shirato, Hiroki
中科院分区：
文献类型：
--
作者：
Park, Hee Chul;Shimizu, Shinichi;Shirato, Hiroki
目的：本研究的目的是评价使用实时跟踪放射治疗（RTRT）系统对宫颈癌患者进行高剂量三维适形增强（3DCB）治疗的临床结果。材料和方法：2001年1月至2004年12月，10例宫颈癌患者采用RTRT系统进行大剂量3DCB治疗。9例患者在3DCB前接受了中位剂量为50戈伊（范围，40-50戈伊）的全骨盆放射治疗（RT）。3DCB的中位剂量为30戈伊（范围：25-30戈伊）。8例患者每周接受两次3DCB，每日剂量为5戈伊。确定的终点是肿瘤缓解、总生存期、局部无失败生存期和无远处转移生存期。从放射治疗开始计算生存期。结果：所有患者在分析时均存活，中位随访时间为17.6个月（范围：4.9-27.3个月）。9例患者完全缓解，1例患者部分缓解。1年和2年局部无失败生存率分别为78.8%和54%。1年和2年无远处转移生存率分别为90%和72%。在1例患者中观察到2级直肠出血的晚期毒性。1例患者出现皮下脓肿。结论：在不能进行腔内近距离放射治疗（ICBT）的情况下，使用高剂量3DCB治疗宫颈癌是安全可行的。目前正在评估3DCB剂量的递增。
Purpose: The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients. Materials and Methods: Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy. Results: All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient. Conclusion: the use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.