Dosimetric comparison of rectal dose-reductive techniques in intra-cavitary brachytherapy for cervical cancer: A retrospective analysis.

IF 1.1 4区医学 Q4 ONCOLOGY

Journal of Contemporary Brachytherapy Pub Date : 2023-08-01 Epub Date: 2023-08-30 DOI:10.5114/jcb.2023.130842

Masafumi Sawada, Yutaka Shiraishi, Hirofumi Toyama, Tomoki Tanaka, Ryuichi Kota, Naoyuki Shigematsu

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引用次数: 0

Abstract

Purpose: Rectal complications in radiotherapy for cervical cancer can highly affect quality of life and correlate with rectal dose. Vaginal gauze packing (VP) and rectal retraction (RR) are widely used for rectal dose reduction in high-dose-rate brachytherapy. We aimed to perform a dosimetric comparison of these two methods for three-dimensional image-guided adaptive brachytherapy.

Material and methods: We retrospectively examined 50 patients with cervical cancer treated with definitive radiotherapy, including intra-cavitary brachytherapy, performed with VP and RR. We extracted two fractions for each patient: one fraction with VP and the next fraction with RR, and then compared dose-volume parameters. In total, 50 fractions each were analyzed in VP and RR groups. Dose to 90% (D₉₀) of high-risk clinical target volume (HR-CTV), and minimum dose to most exposed 2.0 cm³ of other organs at risk (D_2cm³) for the rectum and bladder were determined from planning computed tomography.

Results: There were no significant differences between VP and RR in D₉₀ of HR-CTV (mean: 7.479 Gy and 7.652 Gy, respectively, p = 0.172). The D_2cm³ values for the rectum (mean: 4.234 Gy vs. 4.627 Gy, p = 0.008) and bladder (mean: 5.959 Gy vs. 6.690 Gy, p < 0.001) were significantly lower with VP compared with RR.

Conclusions: VP reduced the dose to the rectum and bladder when compared with RR without impairing the dose to CTV.

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子宫颈癌症腔内近距离放射治疗直肠剂量还原技术的剂量比较：回顾性分析。

目的：癌症放疗中直肠并发症对生活质量有很大影响，并与直肠剂量有关。阴道纱布填塞（VP）和直肠回缩（RR）在高剂量率近距离放射治疗中广泛用于直肠剂量减少。我们的目的是对这两种三维图像引导的自适应近距离放射治疗方法进行剂量学比较。材料和方法：我们回顾性检查了50例接受明确放疗的癌症患者，包括VP和RR的腔内近距离放疗。我们为每个患者提取了两个部分：一个部分带有VP，下一个部分带RR，然后比较剂量-体积参数。VP组和RR组总共各分析了50个组分。通过计划计算机断层扫描确定直肠和膀胱高风险临床目标体积（HR-CTV）的90%（D90）的剂量，以及暴露在2.0cm3其他高危器官中的最小剂量（D2cm3）。结果：在HR-CTV的D90中，VP和RR之间没有显著差异（平均值分别为7.479Gy和7.652Gy，p=0.172）。与RR相比，VP显著降低了直肠和膀胱的D2cm3值（平均值：4.234Gyvs.4.627Gy，p=0.008）和膀胱的D2cm3值（均数：5.959Gyvs.6.690Gy，p<0.001）而不损害对CTV的剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

CiteScore

2.40

自引率

14.30%

发文量

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.