MRI Assessment of Cervical Cancer for Adaptive Radiotherapy
MRI Assessment of Cervical Cancer for Adaptive Radiotherapy
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DOI：
10.1007/s00066-009-1918-7
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发表时间：
2009-05-01
影响因子：
3.1
通讯作者：
Poetter, Richard
中科院分区：
文献类型：
--
作者：
Dimopoulos, Johannes C. A.;Schirl, Gertrude;Poetter, Richard
目的：为了评估的重要性，从MRI获得的信息为自适应宫颈癌radiotherapy.Patients和方法：49例宫颈癌，治疗外束放疗（EBRT）和MRI辅助高剂量率近距离放射治疗+/-伴随顺铂，进行MRI诊断和近距离放射治疗分数的时间。共进行了190次MRI检查。治疗前扫描与临床检查（CE）结果相关。使用MRI和CE进行肿瘤延伸的3-D测量以及肿瘤到骨盆侧壁的距离。肿瘤体积的回归诱导最初EBRT和随后的回归后，每个近距离放射治疗fractions.Results：MRI和CE显示92%的协议，在整体宫旁分期和73%的协议在阴道参与。然而，在25%的宫旁组织检查中，宫旁组织侧（右/左）分类存在分歧。这些患者单侧宫颈移位，对侧侵犯子宫旁组织。治疗前MRI扫描（GTVD）的平均肿瘤体积为61 cm（3）。在四个近距离放射治疗分数的时间，平均值为16厘米（3），10厘米（3），9厘米（3），和8厘米（3），定义为GTVBT加上灰色地带在parametria.Conclusion：CE和MRI的结果同意以及在整体分期方面。当获得从MRI获得的额外知识时，侧特异性宫旁侵犯的临床评估得到改善。肿瘤体积的最大减少发生在EBRT期间，而第一次和随后的近距离放射治疗部分之间的肿瘤消退较小。
Purpose: To assess the importance of the information obtained from MRI for adaptive cervix cancer radiotherapy.Patients and Methods: 49 patients with cervix cancer, treated by external-beam radiotherapy (EBRT) and MRI-assisted high-dose-rate brachytherapy +/- concomitant cisplatin, underwent MRI at diagnosis and at the time of brachytherapy fractions. 190 MRI examinations were performed. Pretreatment scans were correlated with clinical examination (CE) findings. Measurements in 3-D of the tumor extension and also of the distance from the tumor to the pelvic side wall were performed using both MRI and CE. The tumor volume regression induced initially by EBRT and the subsequent regression after each brachytherapy fraction were assessed.Results: MRI and CE showed 92% agreement in overall parametrial staging and 73% agreement in terms of vaginal involvement. There was, however, disagreement in parametrial side (right/left) classification in 25% of the parametria examined. These were patients with unilateral displacement of the cervix and contralateral invasion of the parametrium. The mean tumor volume on the pretreatment MRI scan (GTVD) was 61 cm(3). At the time of the four brachytherapy fractions the mean was 16 cm(3), 10 cm(3), 9 cm(3), and 8 cm(3), defined as the GTVBT plus the gray zones in the parametria.Conclusion: CE and MRI findings agree well in terms of overall staging. The clinical assessment of side-specific parametrial invasion improved when having access to the additional knowledge obtained from MRI. The greatest decrease in tumor volume occurs during EBRT, whereas tumor regression between the first and subsequent brachytherapy fractions is minor.