CT-based interstitial brachytherapy in advanced gynecologic malignancies: outcomes from a single institution experience
| Autor: | Akira Sugimoto, Kathleen Surry, Simran Aulakh, Ericka Wiebe, Frances Whiston, Larry Stitt, Nikhilesh Patil, David D'Souza, Michel Prefontaine |
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| Rok vydání: | 2013 |
| Předmět: |
Oncology
medicine.medical_specialty Genital Neoplasms Female medicine.medical_treatment Brachytherapy Rectum Disease-Free Survival Imaging Three-Dimensional Internal medicine Outcome Assessment Health Care medicine Humans Radiology Nuclear Medicine and imaging External beam radiotherapy Proctitis Equivalent dose Cumulative dose business.industry Interstitial brachytherapy Radiotherapy Dosage Middle Aged medicine.disease medicine.anatomical_structure Toxicity Female Radiology Neoplasm Recurrence Local business |
| Zdroj: | Brachytherapy. 13(3) |
| ISSN: | 1873-1449 |
| Popis: | Purpose To evaluate the clinical outcomes of women receiving a “short” course of high-dose-rate gynecologic interstitial brachytherapy (HDR-ISBT) boost with CT-based 3D planning. Methods and Materials Forty-seven women with no prior radiation received HDR-ISBT from August 2004 to February 2012. The mean external beam radiotherapy dose was 45 Gy. A mean HDR-ISBT boost dose of 18.4 Gy was delivered over 2–4 fractions. Dose volume histograms (DVHs) were computed for organs at risk and clinical target volume. Results With a median followup of 34.8 months, the 3-year local control rate was 68%. Sixteen patients were identified to have tumor recurrence (including eight local). The median time to any recurrence was 26.8 months. Relapse-free survival and overall survival at 3 years was 65% and 73%, respectively. Ten patients experienced Grade 3 late toxicity, mainly vaginal (5) and proctitis (3). The mean prescription volume ( V 100 ) was 85 cc and the mean D 90 to CTV was 98%. The mean cumulative dose to tumor was 69.9 Gy (equivalent dose in 2 Gy). The mean cumulative equivalent dose in 2 Gy to D2cc of bladder and rectum was 60.9 Gy and 63.0 Gy, respectively. Conclusion A “short” course HDR-ISBT is effective, safe, and convenient with acceptable local control and toxicity. Higher dose per fraction is similar to an external beam radiotherapy stereotactic boost with the inherent advantages of brachytherapy. A shorter overall time for HDR-ISBT means less time that patients are immobilized and in hospital, making it less resource intensive than a longer course. |
| Databáze: | OpenAIRE |
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