Initial tumor volume as an important predictor for indication of intra-cavitary brachytherapy, intra-cavitary/interstitial brachytherapy, and multi-catheter sole interstitial brachytherapy in cervical cancer patients treated with chemoradiotherapy.

IF 1.1 4区 医学 Q4 ONCOLOGY Journal of Contemporary Brachytherapy Pub Date : 2023-06-01 DOI:10.5114/jcb.2023.128895
Tadashi Takenaka, Hideya Yamazaki, Gen Suzuki, Koji Masui, Daisuke Shimizu, Tadayuki Kotsuma, Eiichi Tanaka, Ken Yoshida, Kei Yamada
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Abstract

Purpose: Advances in three-dimensional image-guided brachytherapy technique allow for using intra-cavitary and interstitial brachytherapy (ICIS-BT), and sole interstitial brachytherapy (ISBT) in addition to conventional intra-cavitary brachytherapy (ICBT). However, no consensus has been reached regarding the choice of these techniques. The aim of this study was to propose the size criteria for indication of interstitial techniques.

Material and methods: We examined initial gross tumor volume (GTV) at presentation and at each brachytherapy session. Also, dose volume histogram parameters for each modality were compared in 112 patients with cervical cancer treated with brachytherapy (ICBT, 54; ICIS-BT, 11; and ISBT, 47).

Results: The average GTV at diagnosis was 80.9 cm3 (range, 4.4-343.2 cm3), which shrank to 20.6 cm3 (25.5% of initial volume, range, 0.0-124.8 cm3) at initial brachytherapy. GTV > 30 cm3 at brachytherapy and high-risk clinical target volume > 40 cm3 were good threshold values for indication of interstitial technique, and tumors with initial GTV > 150 cm3 could be candidates for ISBT. An ISBT dose of 89.10 Gy can be prescribed in equivalent dose in 2 Gy fractions (range, 65.5-107.6 Gy), which was higher than those of ICIS (73.94 Gy, range, 71.44-82.50 Gy) and ICBT (72.83 Gy, range, 62.50-82.27 Gy) (p < 0.0001).

Conclusions: Initial tumor volume is an important predictor for indication of ICBT and ICIS-BT. ISBT or at least an interstitial technique is recommended for initial GTV > 150 cm3.

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肿瘤初始体积作为宫颈癌放化疗患者腔内近距离放疗、腔内/间质近距离放疗及多导管单间质近距离放疗适应症的重要预测指标
目的:三维图像引导近距离治疗技术的进步使得在常规的腔内近距离治疗(ICBT)之外,可以使用腔内和间质近距离治疗(ICIS-BT),以及单独的间质近距离治疗(ISBT)。然而,对于这些技术的选择尚未达成共识。本研究的目的是提出间质技术指征的大小标准。材料和方法:我们在就诊时和每次近距离治疗时检查初始总肿瘤体积(GTV)。此外,我们还比较了112例接受近距离放疗的宫颈癌患者的剂量-体积直方图参数(ICBT, 54;ICIS-BT 11;ISBT, 47)。结果:诊断时GTV平均为80.9 cm3(范围4.4 ~ 343.2 cm3),近距离治疗时GTV缩小至20.6 cm3(为初始体积的25.5%,范围0.0 ~ 124.8 cm3)。近距离GTV > 30 cm3和高危临床靶体积> 40 cm3是间质技术适应症的良好阈值,初始GTV > 150 cm3的肿瘤可作为间质技术的候选者。89.10 Gy的ISBT剂量可按2 Gy分数(范围65.5 ~ 107.6 Gy)规定当量剂量,高于ICIS (73.94 Gy,范围71.44 ~ 82.50 Gy)和ICBT (72.83 Gy,范围62.50 ~ 82.27 Gy) (p < 0.0001)。结论:肿瘤初始体积是ICBT和ICIS-BT适应症的重要预测指标。对于初始GTV > 150 cm3的患者,建议采用ISBT或至少间隙技术。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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