In this study, high risk clinical target volumes (HR-CTVs) according to GEC-ESTRO guideline were contoured retrospectively based on CT images taken at the time of high-dose rate intracavitary brachytherapy (HDR-ICBT) and correlation between clinical outcome and dose of HR-CTV were analyzed.
Methods:
Our study population consists of 51 patients with cervical cancer (Stages IB-IVA) treated with 50 Gy external beam radiotherapy (EBRT) using central shield combined with 2-5 times of 6 Gy HDR-ICBT with or without weekly cisplatin. Dose calculation was based on Manchester system and prescribed dose of 6 Gy were delivered for point A.
CT images taken at the time of each HDR-ICBT were reviewed and HR-CTVs were contoured. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (alpha/beta = 10 Gy).
Results:
Three-year overall survival, Progression-free survival, and local control rate was 82.4%, 85.3% and 91.7%, respectively.
Median cumulative dose of HR-CTV D90 was 65.0 Gy (52.7-101.7 Gy). Median length from tandem to the most lateral edge of HR-CTV at the first ICBT was 29.2 mm (range, 18.0-51.9 mm).
On univariate analysis, both LCR and PFS was significantly favorable in those patients D90 for HR-CTV was 60 Gy or greater (p = 0.001 and 0.03, respectively). PFS was significantly favorable in those patients maximum length from tandem to edge of HR-CTV at first ICBT was shorter than 3.5 cm (p = 0.042).
Conclusion:
Volume-dose showed a relationship to the clinical outcome in CT based brachytherapy for cervical carcinoma.
Author: Naoya MurakamiTakahiro KasamatsuAkihisa WakitaSatoshi NakamuraHiroyoki OkamotoKoji InabaMadoka MorotaYoshinori ItoMinako SumiJun Itami
Credits/Source: BMC Cancer 2014, 14:447
Published on: 2014-06-17
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