Dose-effect relationship in external beam radiotherapy combined with brachytherapy for cervical cancer: A systematic review.

IF 1.1 4区 医学 Q4 ONCOLOGY
Journal of Contemporary Brachytherapy Pub Date : 2024-06-01 Epub Date: 2024-06-24 DOI:10.5114/jcb.2024.140760
Ning Wu, Mingwei Bu, Hairong Jiang, Xin Mu, Hongfu Zhao
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Abstract

Purpose: External beam radiotherapy with concurrent chemotherapy combined with brachytherapy has been described as the first treatment choice for locally advanced cervical cancer. This study aimed to systematically review the dose-effect relationship (DER) of target volumes and organs at risk (OARs) in external beam radiotherapy combined with brachytherapy for cervical cancer.

Material and methods: Studies reporting DER in radical radiotherapy for cervical cancer were determined by searching PubMed, Web of Science, and Cochrane Library databases till Jan 20, 2023. Dose parameters of DER, end-point of tumor control or type and grade of side effects of OARs as well as prediction results were analyzed from included studies. Coordinates of DER curves from the included studies were extracted and DER curves were reconstructed in the same coordinate system for comparison.

Results: Thirty studies, including eleven dose-response relationships for clinical end-points, and nineteen dose-toxicity relationships for OARs were evaluated in systematic review. The most common dose-response relationship between the same dose parameter and the same clinical end-point was HR-CTV D90 vs. local tumor control, while it was D2cc of rectum versus rectal grade 2-4 side effects for dose-toxicity relationship.

Conclusions: In the radical radiotherapy of cervical cancer, there were significant DERs for target volumes and OARs. Considering the interference of these factors, DERs in sub-group patients would provide precise and individualized dose constraints of radiotherapy for cervical cancer in the future.

外束放疗联合近距离治疗宫颈癌的剂量效应关系:系统综述。
目的:外束放疗联合近距离化疗已成为局部晚期宫颈癌的首选治疗方法。本研究旨在系统回顾外束放疗联合近距离治疗宫颈癌靶体积与危险器官(OARs)的剂量效应关系。材料和方法:通过检索PubMed、Web of Science和Cochrane图书馆数据库,截至2023年1月20日,确定报道宫颈癌根治性放疗中DER的研究。从纳入的研究中分析DER的剂量参数、肿瘤控制终点或OARs副作用的类型和分级以及预测结果。提取纳入研究的DER曲线坐标,在同一坐标系下重建DER曲线进行比较。结果:系统评价了30项研究,包括11项临床终点的剂量-反应关系和19项OARs的剂量-毒性关系。相同剂量参数和相同临床终点之间最常见的剂量-反应关系是HR-CTV D90 vs局部肿瘤对照,而剂量-毒性关系是直肠D2cc vs直肠2-4级副作用。结论:在宫颈癌根治放疗中,靶体积和OARs存在显著的der。考虑到这些因素的干扰,亚组患者的der可为今后宫颈癌放疗提供精确、个体化的剂量约束。
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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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