Clinical implementation of three-dimensional standardized template-guided brachytherapy for patients with locally advanced cervical cancer

IF 1.1 4区 医学 Q4 ONCOLOGY
Yeqiang Tu, Jiahao Wang, Yukai Chen, Yuanyuan Chen, Qiu Tang
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引用次数: 0

Abstract

Purpose:
Although customized three-dimensional (3D) templates have shown advantages in brachytherapy, widespread application is still full of challenges. The present work proposed the use of a commercial 3D standardized template-guided intracavitary/interstitial brachytherapy (IC/ISBT) that could provide simple and reproducible needles’ insertion.

Material and methods:
43 patients received external beam radiotherapy (EBRT) with 45-50.4 Gy and subsequent IC/ISBT with 28 Gy in 4 fractions. In terms of IC/ISBT, 24 patients were treated with 3D standardized templates (ST group), and 19 patients were treated using free-hand implantation (FH group). Consistency of implantation for all needles and dosimetric differences for target and organs at risk (OARs) were then compared between two groups.

Results:
The mean variation of tip position between insertions for needles was 1.41 mm and 2.74 mm in ST group and FH group, respectively (p < 0.001). ST group was superior in terms of dosimetric conformity index (CI) and D90 for high-risk clinical target volume (HR-CTV), significantly improving to 23.21% (p < 0.001) and 3.58% (p = 0.031) compared with FH group. The D2cc of the bladder and sigmoid in the ST group were lower than those in the FH group (p < 0.05). Meanwhile, a strong correlation between the volume of HR-CTV and its CI in the ST group (R = 0.865, p < 0.001) was found with Spearman’s correlation analysis.

Conclusions:
The implementation of 3D standardized template can potentially improve the precision and consistency in the needle insertion procedure that may replace some customized 3D templates, and achieve clinical satisfied dose distribution in IC/ISBT plans for patients with LACC.

针对局部晚期宫颈癌患者的三维标准化模板引导近距离放射治疗的临床实施情况
目的:尽管定制的三维(3D)模板在近距离治疗中显示出优势,但广泛应用仍充满挑战。材料与方法:43 名患者接受了 45-50.4 Gy 的体外放射治疗(EBRT),随后接受了 28 Gy 的 IC/ISBT 治疗,分 4 次进行。在 IC/ISBT 治疗中,24 名患者采用三维标准化模板(ST 组),19 名患者采用徒手植入法(FH 组)。结果:ST 组和 FH 组植入针尖位置的平均差异分别为 1.41 毫米和 2.74 毫米(p <0.001)。ST 组在高危临床靶体积(HR-CTV)的剂量符合性指数(CI)和 D90 方面优于 FH 组,分别显著提高到 23.21% (p < 0.001) 和 3.58% (p = 0.031)。ST 组膀胱和乙状结肠的 D2cc 均低于 FH 组(p < 0.05)。结论:三维标准化模板的实施有可能提高进针过程的精确性和一致性,从而取代一些定制的三维模板,并在 LACC 患者的 IC/ISBT 计划中实现临床满意的剂量分布。
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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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