Impact of pre-brachytherapy magnetic resonance imaging on dose-volume histogram of locally advanced cervical cancer patients treated with radiotherapy including high-dose-rate brachytherapy
| Autor: | Toshiyuki Okumura, Hideyuki Sakurai, Toshiki Ishida, Keiichiro Baba, Kenji Kawakita, Toyomi Sato, Keiko Murofushi, Tsukasa Saida Sasaki |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0106 biological sciences
interstitial brachytherapy Dose-volume histogram medicine.medical_specialty cervical cancer medicine.medical_treatment Brachytherapy Rectum 01 natural sciences medicine Parametrium Radiology Nuclear Medicine and imaging image-guided adaptive brachytherapy dose-volume histogram Cervical cancer intracavitary brachytherapy Original Paper medicine.diagnostic_test business.industry 010401 analytical chemistry Magnetic resonance imaging medicine.disease High-Dose Rate Brachytherapy 0104 chemical sciences Radiation therapy medicine.anatomical_structure Oncology Medicine Radiology business 010606 plant biology & botany |
| Zdroj: | Journal of Contemporary Brachytherapy Journal of Contemporary Brachytherapy, Vol 13, Iss 1, Pp 32-38 (2021) |
| ISSN: | 1689-832X |
| Popis: | Purpose This study investigated the suitability of brachytherapy technique selection based on pre-brachytherapy magnetic resonance imaging (MRI) findings in cervical cancer by evaluating dose-volume histogram parameters. Material and methods We retrospectively evaluated data from 61 patients with cervical cancer who underwent pre-brachytherapy MRI within 7 days before their first high-dose-rate brachytherapy treatment, selected according to pre-brachytherapy MRI findings. Combined intracavitary brachytherapy with interstitial techniques (IC/ISBT) or interstitial brachytherapy (ISBT) were favored treatments for poor-responding tumors after concurrent chemoradiotherapy, asymmetrical tumors, bulky parametrial extensions, bulky primary disease, and extensive paravaginal or distal vaginal involvement. Intracavitary brachytherapy (ICBT) was the preferred treatment for small tumors without extensive involvement of the vagina and parametrium. Results The median tumor size was 58 mm on pre-treatment MRI and 38 mm on pre-brachytherapy MRI. On pre-brachytherapy MRI, 13 patients had a tumor with severe vaginal invasion, 15 patients presented with an asymmetrical bulky tumor, and 4 patients had bulky residual tumors. IC/ISBT or ISBT were administered to 26 patients (43%). Median equivalent dose in 2 Gy fractions of clinical target volume D90 was 70.8 Gy for all patients. Median clinical target volume D90 in each brachytherapy session exceeded the prescribed dose in both patients treated with ICBT and IC/ISBT or ISBT. Median equivalent dose in 2 Gy fractions of D2cc to the bladder, sigmoid colon, and rectum was 69.5, 52.0, and 58.4 Gy, respectively. All cases remained within the doses recommended for organs at risk. Conclusions Pre-brachytherapy MRI may be helpful in selecting suitable candidates for each type of brachytherapy and deliver the recommended doses to the tumor and organs at risk, particularly in cases with large tumors, poor response to concurrent chemoradiotherapy, asymmetrical tumors, severe vaginal invasion, extensive parametrial invasion, and/or corpus invasion. |
| Databáze: | OpenAIRE |
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