高剂量率近距离放射治疗手术切除的子宫内膜癌:约 60 例

H. Fares, M. Taouchikht, S. Abdou, A. Lachgar, K. Nouni, H. Kacemi, T. Kebdani, K. Hassouni
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摘要

导言:子宫内膜癌是 RABAT 国家肿瘤研究所放疗近距离治疗部的第三大妇科乳腺癌。近距离放射治疗在治疗策略中占有重要地位。本研究的目的:通过三维剂量规划和毒性评估,分析靶体积的覆盖率以及危险器官的剂量。材料与方法:这是一项回顾性研究,研究对象是2018年1月至2020年12月期间在RABAT国家肿瘤研究所放疗科收集的60例通过高剂量率近距离放射治疗而未进行体外放疗或化疗的子宫内膜癌手术病例。在第一次治疗时进行了一次不注射的剂量测定扫描,用于划定临床解剖靶体积(CTV)。我们评估了临床靶体积的 D100 以及膀胱、直肠和小肠的 D2 cm3。我们还分析了急性泌尿生殖系统和胃肠道毒性。结果:患者的平均年龄为49岁。子宫内膜样癌占98.5%,其中一例为粘液腺癌。所有患者均接受了手术治疗。近距离放射治疗方案为每周一次,每次3 Ã- 7 Gy (75%)或4 Ã- 5.5 Gy (17%)。膀胱、直肠和小肠每次接受的平均D2 cm3剂量分别为4.06 Gy、4.9 Gy和2.8 Gy。在泌尿生殖系统毒性方面,我们发现了2例1级膀胱炎、1例2级膀胱炎、2例1级粘膜炎和1例2级粘膜炎。结论:高剂量率近距离放射治疗在子宫内膜癌的治疗策略中占有重要地位。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
HIGH DOSE RATE BRACHYTHERAPY IN THE TREATMENT OF OPERATED ENDOMETRIAL CANCERS: ABOUT 60 CASES
Introduction:Endometrial cancer is the third gyneco-mammary cancer in the radiotherapy-brachytherapy department of the RABAT national oncology institute.Brachytherapy has an important place in the therapeutic strategy. The objective of the study:Is to analyze the coverage of target volumes as well as the dose to organs at risk with three-dimensional dosimetric planning and toxicity assessment. Material and methods:This is a retrospective study of 60 cases of operated endometrial cancers treated by high dose rate brachytherapy without external radiotherapy or chemotherapy collected in the radiotherapy department of the National Institute of Oncology RABAT between January 2018 and December 2020. A dosimetric scan without injection was performed at the first session and was used to delineate the clinical anatomic target volume (CTV). We evaluated the D100 of the clinical target volume and the D2 cm3 of the bladder, rectum and small intestine. We also analyzed acute genitourinary and gastrointestinal toxicity. Results:The average age of the patients was 49 years. Endometrioid carcinoma accounted for 98.5%, with one case of mucinous carcinoma. All patients underwent surgery.The brachytherapy protocol used was 3 × 7 Gy (75%) or 4 × 5.5 Gy (17%) in weekly sessions A single patient received a reduced total dose of 19.8 Gy in 3 fractions of 5.5 Gy due to a high rectal dose.The average target volume coverage (D100) was 96.50%.The average D2 cm3 per session received by the bladder, rectum and small intestine were 4.06 Gy, 4.9 Gy and 2.8 Gy, respectively.Regarding genitourinary toxicity, we noted two grade 1 cystitis, one grade 2, two grade 1 mucositis and one grade 2.For gastrointestinal toxicity, no cases of grade greater than 1 were noted.No grade 3 or 4 toxicities were recorded. Conclusion:High dose rate brachytherapy has an important place in the therapeutic strategy for endometrial cancer.The very low toxicity recalls the good tolerance of this treatment whichapplies to the entire population.
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