Effective timing of hyaluronate gel injection in image-guided adaptive brachytherapy for uterine cervical cancer: a proposal of the 'adjusted dose score'.

Autor:	Miyata Y; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Ogo E; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Murotani K; Biostatistics Center, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Tsuda N; Department of Obstetrics and Gynecology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Suzuki G; Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan., Tsuji C; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Akeda R; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Muraki K; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Hattori C; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan., Abe T; Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
Jazyk:	angličtina
Zdroj:	Journal of radiation research [J Radiat Res] 2024 May 23; Vol. 65 (3), pp. 393-401.
DOI:	10.1093/jrr/rrae031
Abstrakt:	Hyaluronate gel injection (HGI) in the rectovaginal septum and vesicovaginal septum is effective in the setting of high-dose-rate image-guided adaptive brachytherapy (IGABT) for cervical cancer. We aimed to retrospectively investigate optimal conditions for HGI to achieve optimal dose distribution with a minimum number of HGI. We classified 50 IGABT plans of 13 patients with cervical cancer who received IGABT both with and without HGI in the rectovaginal septum and vesicovaginal septum into the following two groups: plan with (number of plans = 32) and plan without (number of plans = 18) HGI. The irradiation dose parameters of high-risk clinical target volume (CTVHR) and organs at risk per fraction were compared between these groups. We also developed the adjusted dose score (ADS), reflecting the overall irradiation dose status for four organs at risk and CTVHR in one IGABT plan and investigated its utility in determining the application of HGI. HGI reduced the maximum dose to the most exposed 2.0 cm3 (D2.0 cm3) of the bladder while increasing the minimum dose covering 90% of CTVHR and the percentage of CTVHR receiving 100% of the prescription dose in one IGABT plan without causing any associated complications. An ADS of ≥2.60 was the optimum cut-off value to decide whether to perform HGI. In conclusion, HGI is a useful procedure for improving target dose distribution while reducing D2.0 cm3 in the bladder in a single IGABT plan. The ADS can serve as a useful indicator for the implementation of HGI. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.)
Databáze:	MEDLINE
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