Retrospective DVH analysis of point A based intracavitary brachytherapy for uterine cervical cancer
Retrospective DVH analysis of point A based intracavitary brachytherapy for uterine cervical cancer
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DOI：
10.1093/jrr/rrz099
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发表时间：
2020-03-01
影响因子：
2
通讯作者：
Sakata, Koh-ichi
中科院分区：
文献类型：
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作者：
Someya, Masanori;Hasegawa, Tomokazu;Sakata, Koh-ichi
体外放射治疗（EBRT）与腔内近距离放射治疗（ICBT）相结合是宫颈癌决定性治疗的重要手段。在接受放疗的宫颈癌患者中，我们评估了与剂量-体积直方图参数相关的治疗结果，包括基于计算机断层扫描（CT）的ICBT高危临床靶体积（HR-CTV）。2010 - 2015年连续89例宫颈癌患者，多采用40 Gy EBRT分20次治疗，18 Gy ICBT分3次治疗A点。在ICBT期间获得CT扫描。计算HR-CTV D90，并将ICBT和EBRT的总剂量折合成2 Gy的当量剂量（EQD2）。根据HR-CTV D90的EQD2分为4组，接受bbb80、70-80、60-70和= 22 cc患者的3年局部无复发生存率分别为95.2、78.4、52.7和42.9%，以及HR-CTV D90的EQD2 = 4个周期)是总生存率的重要决定因素。HR-CTV D90是局部复发的重要预后指标。HR-CTV D90 >70 Gy可获得较好的局部控制，特别是对于HR-CTV较大的患者（初始ICBT时>= 22 cc）。
Combining external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT) is important for definitive treatment of cervical cancer. In cervical cancer patients receiving radiotherapy, we evaluated treatment outcomes in relation to dose-volume histogram parameters, including the computed tomography (CT)-based high-risk clinical target volume (HR-CTV) for ICBT. Between 2010 and 2015, 89 consecutive cervical cancer patients were mostly treated with 40 Gy of EBRT in 20 fractions and 18 Gy of ICBT prescribed to point A in 3 fractions. CT scans were obtained during ICBT. The HR-CTV D90 was calculated and the total doses of ICBT and EBRT were converted to the equivalent dose in 2 Gy fractions (EQD2). When the patients were divided into four groups according to EQD2 of the HR-CTV D90, the 3-year local recurrence-free survival rates were 95.2, 78.4, 52.7 and 42.9% for patients receiving >80, 70-80, 60-70 and = 22 cc and EQD2 of the HR-CTV D90 was = 4 cycles) were significant determinants of overall survival. HR-CTV D90 was an important prognostic indicator for local recurrence. HR-CTV D90 >70 Gy is required for the better local control, especially in patients with a larger HR-CTV (>= 22 cc at initial ICBT).