Abstract:
PURPOSE:To explore the dosimetric advantage of target volume and surrounding normal tissue by using interstitial (IS) brachytherapy (BT) based on three-dimensional CT in locally advanced cervical cancer, as a simple and effective clinical treatment approach. METHODS AND MATERIALS:Fifty-two patients with poor tumor response to external beam radiotherapy and a residual tumor >5 cm at the time of the first BT were included. IS BT was performed using a "hybrid" applicator combining uterine tandem and free metal needles based on three-dimensional CT. The high-risk clinical target volume (HR-CTV), intermediate-risk clinical target volume, and organs at risk were contoured. The total dose, including external beam radiotherapy (45 Gy in 25 fractions) and high-dose-rate BT (30 Gy in 5 fractions), was biologically normalized to conventional 2-Gy fractions. D90 and D100 for HR-CTV and intermediate-risk clinical target volume and D2cc for the bladder, rectum, and sigmoid were analyzed. RESULTS:The mean D90 value for HR-CTV was 88.4 ± 3.5 Gy. Totally, 88.5% of the patients received D90 for HR-CTV ≥87 Gy. The D2cc for the bladder, rectum, and sigmoid were 81.1 ± 5.6, 65.7 ± 5.1, and 63.1 ± 5.4 Gy, respectively. The mean number of needles was 6.9 ± 1.3 for each application. IS BT was associated with minor complications. CONCLUSION:IS BT using the "hybrid" applicator provides a dosimetric advantage for target volume and organs at risk in large-volume (>5 cm) tumors and is, thereby, clinically feasible. However, the long-term curative effect and possible toxicity need further clinical observation.
journal_name
Brachytherapyjournal_title
Brachytherapyauthors
Liu ZS,Guo J,Lin X,Wang HY,Qiu L,Ren XJ,Li YF,Zhang BY,Wang TJdoi
10.1016/j.brachy.2016.06.004subject
Has Abstractpub_date
2016-09-01 00:00:00pages
562-9issue
5eissn
1538-4721issn
1873-1449pii
S1538-4721(16)30495-0journal_volume
15pub_type
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