Dose-volume parameters and clinical outcome of CT-guided free-hand high-dose-rate interstitial brachytherapy for cervical cancer  

作　　者：Yi Wang Wei-Jun Ye Le-Hui Du Ai-Ju Li Yu-Feng Ren Xin-Ping Cao 

机构地区：[1]State Key Laboratory of Oncology in South China [2]Department of Radiation Oncology,Sun Yat-sen University Cancer Center

出　　处：《Chinese Journal of Cancer》2012年第12期598-604,共7页

摘　　要：Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.Currently, image-based 3-dimentional （3D） planning brachytherapy allows for a better assessment of gross tumor volume （GTV） and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography （CT）-guided free-hand high-doserate interstitial brachytherapy （HDRISBT） technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram （DVH） parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 （range, 4-7） implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume （D90） was 45 （range, 33-54） Gyα/β10 for high-risk clinical target volume （HR-CTV） and 30 （range, 20-36） Gyα/β10 for intermediate-risk clinical target volume （IR-CTV）. The percentage of the CTV covered by the prescribed dose （V100） of HR-CTV with brachytherapy alone was 81.9%-99.2% （median, 96.7%）. With an additional dose of external beam radiotherapy （EBRT）, the median D90 was 94 （range, 83-104） Gyα/β10 for HR-CTV and 77 （range, 70-87） Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume （D100） was 75 （range, 66-84） Gyα/β10 for HR-CTV and 65 （range, 57-73） Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume （D200） was 73-96 （median, 83） Gyα/β3 for the bladder, 64-98 （median, 73） Gyα/β3 for the rectum, and 52-69 （median, 61） Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months （range, 3-24 months）, two patients experienced local failure, and 1 showed internal lilac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical can

关 键 词：子宫颈癌 放射治疗 体积参数 剂量率 CTV 近距离 临床 引导 

分 类 号：R737.33[医药卫生—肿瘤]