Rectum and bladder spacing in cervical cancer brachytherapy using a novel injectable hydrogel compound
Rectum and bladder spacing in cervical cancer brachytherapy using a novel injectable hydrogel compound
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DOI：
10.1016/j.brachy.2017.04.236
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发表时间：
2017-09-01
期刊：
影响因子：
1.9
通讯作者：
Viswanathan, Akila N.
中科院分区：
文献类型：
--
作者：
Damato, Antonio L.;Kassic, Megan;Viswanathan, Akila N.
目的：本研究的目的是在女性身体的宫颈、直肠和膀胱之间注射一种新型水凝胶(TracelT；Augmenix，Waltham，MA)，以比较和补充现有的纱布填充标准，用于宫颈癌近距离放射治疗计划中危险器官的保留。方法：本研究采用T2加权MRI和CT成像来比较三种情况：(1)单独使用纱布填充，(2)水凝胶注射在宫颈穹隆和直肠阴道隔，以及(3)纱布填充和水凝胶注射。对水凝胶分布进行了评价。收集直肠、膀胱和乙状结肠2厘米(3)体积(D-2CC)的剂量。统计学意义(p<；0.05)采用双尾配对t检验。结果：5具身体均成功地将水凝胶从宫颈注入膀胱和直肠。间隔区在CT和MRI上都很容易识别。在填充的同时使用水凝胶，直肠D-2CC剂量减少了22%(p=0.02)，膀胱D-2CC剂量减少了10%(p=0.27)，乙状结肠D-2CC剂量没有变化。仅使用水凝胶和仅使用纱布填充之间没有差异。结论：我们的结果显示，在使用水凝胶和纱布填充的同时，直肠D-2CC显著降低，在宫颈癌治疗中，TracelT水凝胶有望成为一种间隔物。(C)2017年美国近距离放射治疗学会。爱思唯尔公司出版，版权所有。
PURPOSE: The aim of this study was to evaluate injection of a novel hydrogel (TracelT; Augmenix, Waltham, MA) between the cervix, rectum, and bladder in female cadavers compared with, and in addition to, the current standard of gauze packing, for organ-at-risk sparing in cervical cancer brachytherapy planning.METHODS AND MATERIALS: This brachytherapy cadaver study used T2-weighted MRI and CT imaging to compare three scenarios: (1) gauze packing alone, (2) hydrogel.injection placed in the cervical fornices and rectovaginal septum, and (3) gauze packing in conjunction with hydrogel injection. Hydrogel distribution was evaluated. Doses to 2 cm(3) volumes (D-2cc) for the rectum, bladder, and sigmoid were collected. Statistical significance (p < 0.05) was evaluated using a two-tailed paired t test.RESULTS: Hydrogel was successfully injected to space the bladder and rectum from the cervix in all five cadavers. The spacer was easily identifiable on both CT and MRI. The use of hydrogel in addition to packing resulted in a 22% decrease in rectum D-2cc dose (p = 0.02), a 10% decrease in bladder D-2cc (p = 0.27), and no change in sigmoid D-2cc dose. No difference was observed between hydrogel only vs. gauze packing only.CONCLUSIONS: Our results revealed a significant clinically meaningful decrease in rectal D-2cc associated with the use of hydrogel in addition to gauze packing TracelT hydrogel holds promise as a spacer in cervical cancer therapy. (C) 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.