Who Really Benefits from 3D-Based Planning of Brachytherapy for Cervical Cancer?.
10.3346/jkms.2018.33.e135
- Author:
In Bong HA
1
;
Bae Kwon JEONG
;
Ki Mun KANG
;
Hojin JEONG
;
Yun Hee LEE
;
Hoon Sik CHOI
;
Jong Hak LEE
;
Won Jun CHOI
;
Jeong Kyu SHIN
;
Jin Ho SONG
Author Information
1. Department of Radiation Oncology, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
- Publication Type:Original Article
- Keywords:
Cervical Cancer;
Brachytherapy;
3-D Imaging;
Radiotherapy Planning
- MeSH:
Brachytherapy*;
Colon, Sigmoid;
Humans;
Imaging, Three-Dimensional;
Korea;
Magnetic Resonance Imaging;
Organs at Risk;
Radiotherapy;
Retrospective Studies;
Uterine Cervical Neoplasms*
- From:Journal of Korean Medical Science
2018;33(18):e135-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Although intracavitary radiotherapy (ICR) is essential for the radiation therapy of cervical cancer, few institutions in Korea perform 3-dimensional (3D)-based ICR. To identify patients who would benefit from 3D-based ICR, dosimetric parameters for tumor targets and organs at risk (OARs) were compared between 2-dimensional (2D)- and 3D-based ICR. METHODS: Twenty patients with locally advanced cervical cancer who underwent external beam radiation therapy (EBRT) following 3D-based ICR were retrospectively evaluated. New 2D-based plans based on the Manchester system were developed. Tumor size was measured by magnetic resonance imaging. RESULTS: The mean high risk clinical target volume (HR-CTV) D90 value was about 10% lower for 2D- than for 3D-based plans (88.4% vs. 97.7%; P = 0.068). Tumor coverage did not differ between 2D- and 3D-based plans in patients with tumors ≤ 4 cm at the time of brachytherapy, but the mean HR-CTV D90 values in patients with tumors > 4 cm were significantly higher for 3D-based plans than for 2D-based plans (96.0% vs. 78.1%; P = 0.017). Similar results were found for patients with tumors > 5 cm initially. Other dosimetric parameters for OARs were similar between 2D- and 3D-based plans, except that mean sigmoid D2cc was higher for 2D- than for 3D-based plans (67.5% vs. 58.8%; P = 0.043). CONCLUSION: These findings indicate that 3D-based ICR plans improve tumor coverage while satisfying the dose constraints for OARs. 3D-based ICR should be considered in patients with tumors > 4 cm size at the time of brachytherapy or > 5 cm initially.
