局部晚期宫颈癌单次应用多分次CT引导间质高剂量率近距离放射治疗的临床疗效：多机构初步经验

IF 1.1 4区医学 Q4 ONCOLOGY

Journal of Contemporary Brachytherapy Pub Date : 2023-12-29 DOI:10.5114/jcb.2023.134169

Eugene T Yap, Mark P Dumago, Carl Jay Jainar, Maureen Bojador, Stellar Marie Cabrera, Gil S Gonzalez, Jocelyn Z Mariano, Aida Bautista, Jhustine Mababangloob, Janell Marie Genson, Teresa Sy Ortin, Warren R Bacorro

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引用次数: 0

摘要

目的：该研究旨在评估局部晚期宫颈癌患者在单次应用多分次计算机断层扫描（CT）引导下进行四次分次间质高剂量率近距离放射治疗的安全性和临床疗效。材料和方法：研究纳入了接受外照射±每周顺铂治疗后，再接受单次应用多分次CT引导下进行四次分次间质高剂量率近距离放射治疗的局部晚期宫颈癌IIB-IVA期患者。结果：2018年1月至2022年12月期间，共纳入22例患者。临床分期分布如下：IIB - 13.6%，IIIB - 27.3%，IIIC - 22.7%，IVA - 36.4%。平均高危临床靶体积（HR-CTV）为 66.19 ± 32.69 cm3，HR-CTV D90 剂量为 86.8 ± 1.7 Gy。膀胱、直肠和乙状结肠的 2 cc 剂量分别为 84.6 ±2.8 Gy、71.5 ±2.4 Gy 和 65.6 ±4.0 Gy。平均治疗时间为 66 ± 21 天。中位随访时间为 11.5 个月（5-44 个月），未达到中位生存率和局部控制率。一年局部控制率、一年无进展生存率和一年总生存率分别为82%、66%和78%。单变量分析显示，总体治疗时间是唯一与所有肿瘤结果相关的变量。急性毒性方面，4名患者出现3级毒性，1名患者出现4级感染毒性。结论：初步结果表明，在局部晚期宫颈癌的治疗中，单次应用多分次CT引导间质近距离放射治疗分四次进行似乎是可行且安全的，但还需要更多的证据来得出更有效的结论。

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Clinical outcomes of single application multi-fractionated CT-guided interstitial high-dose-rate brachytherapy for locally advanced cervical cancer: A multi-institution initial experience

Purpose:
The aim of the study was to evaluate the safety and clinical outcomes of single application multi-fractionated computed tomography (CT)-guided interstitial high-dose-rate brachytherapy given in four fractions in locally advanced cervical cancer.

Material and methods:
Patients with locally advanced cervical cancer stage IIB-IVA treated definitively with external radiation ± weekly cisplatin, followed by single application multi-fractionated CT-guided interstitial high-dose-rate brachytherapy in four fractions were included. Dosimetry data, clinical response, and toxicity records were reviewed.

Results:
Between January 2018 and December 2022, twenty-two patients were included. Clinical stage distribution was as follows: IIB – 13.6%, IIIB – 27.3%, IIIC – 22.7%, and IVA – 36.4%. Mean high-risk clinical target volume (HR-CTV) was 66.19 ±32.69 cm³, and HR-CTV D90 dose was 86.8 ±1.7 Gy. 2 cc doses to bladder, rectum, and sigmoid were 84.6 ±2.8 Gy, 71.5 ±2.4 Gy, and 65.6 ±4.0 Gy, respectively. Mean overall treatment time was 66 ±21 days. With a median follow-up of 11.5 months (range, 5-44 months), median survival and local control were not achieved. One-year local control rate, one-year progression-free survival, and one-year overall survival were 82%, 66%, and 78%, respectively. Univariate analysis showed overall treatment time to be the only variable associated with all oncologic outcomes. For acute toxicity, grade 3 toxicity in four patients and grade 4 toxicity of infection in one patient were observed. For late toxicity, grade 3 gastrointestinal toxicity was noted in two patients.

Conclusions:
Initial results suggest that single application multi-fractionated CT-guided interstitial brachytherapy given in four fractions in locally advanced cervical cancer seems to be feasible and safe, but additional evidence is needed to generate more validated conclusions.

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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.