Clinical outcome of adjuvant treatment of endometrial cancer using aperture-based intensity-modulated radiotherapy
| Autor: | Isabelle Germain, Luc Gingras, André Fortin, M. Bouchard, Sylvain Nadeau, Luc Beaulieu, F Beaulieu, Paul-Émile Raymond |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Cancer Research
medicine.medical_specialty endocrine system diseases medicine.medical_treatment Brachytherapy Urinary Bladder Pilot Projects Hysterectomy Radiation Dosage Disease-Free Survival Bone Marrow otorhinolaryngologic diseases medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Radiation treatment planning Prospective cohort study Radiation Injuries neoplasms Chronic toxicity Aged Radiation business.industry Endometrial cancer Rectum Radiotherapy Dosage Middle Aged medicine.disease Acute toxicity Surgery Endometrial Neoplasms Radiation therapy Intestines stomatognathic diseases Treatment Outcome Oncology Female Radiotherapy Adjuvant Radiology Radiotherapy Intensity-Modulated business therapeutics Follow-Up Studies |
| Zdroj: | International journal of radiation oncology, biology, physics. 71(5) |
| ISSN: | 0360-3016 |
| Popis: | Purpose To assess disease control and acute and chronic toxicity with aperture-based intensity-modulated radiotherapy (AB-IMRT) for postoperative pelvic irradiation of endometrial cancer. Methods and Materials Between January and July 2005, after hysterectomy for endometrial cancer, 15 patients received 45 Gy to the pelvis using AB-IMRT. The AB-IMRT plans were generated by an in-house treatment planning system (Ballista). The AB-IMRT plans were used for treatment and were dosimetrically compared with three other approaches: conventional four-field, enlarged four-field, and beamlet-based IMRT (BB-IMRT). Disease control and toxicity were prospectively recorded and compared with retrospective data from 30 patients treated with a conventional four-field technique. Results At a median follow-up of 27 months (range, 23–30), no relapse was noted among the AB-IMRT group compared with five relapses in the control group (p = 0.1). The characteristics of each group were similar, except for the mean body mass index, timing of brachytherapy, and applicator type used. Patients treated with AB-IMRT experienced more frequent Grade 2 or greater gastrointestinal acute toxicity (87% vs. 53%, p = 0.02). No statistically significant difference was noted between the two groups regarding the incidence or severity of chronic toxicities. AB-IMRT plans significantly improved target coverage (93% vs. 76% of planning target volume receiving 45 Gy for AB-IMRT vs. conventional four-field technique, respectively). The sparing of organs at risk was similar to that of BB-IMRT. Conclusion The results of our study have shown that AB-IMRT provides excellent disease control with equivalent late toxicity compared with the conventional four-field technique. AB-IMRT provided treatment delivery and quality assurance advantages compared with BB-IMRT and could reduce the risk of second malignancy compared with BB-IMRT. |
| Databáze: | OpenAIRE |
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