J Cancer 2018; 9(9):1635-1641. doi:10.7150/jca.23974 This issue Cite

Research Paper

The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer

Yun-Zhi Dang*, Pei Li*, Jian-Ping Li, Fei Bai, Ying Zhang, Yun-Feng Mu, Wei-Wei Li, Li-Chun Wei, Mei Shi

Department of Radiation Oncology, Xijing Hospital, The Fourth Military Medical University, 17 Changle Western Road, Xi'an 710032, China
* These authors contributed equally.

Citation:
Dang YZ, Li P, Li JP, Bai F, Zhang Y, Mu YF, Li WW, Wei LC, Shi M. The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer. J Cancer 2018; 9(9):1635-1641. doi:10.7150/jca.23974. https://www.jcancer.org/v09p1635.htm
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Abstract

Purpose: To report the efficacy and late side effects(LSEs) of CT-based image-guided brachytherapy for the treatment of cervical cancer.

Materials: Between 2008 and 2014, 100 patients with FIGO stage IIB-IVA cervical carcinoma were analyzed. The patients received pelvic irradiation (45-50 Gy in 25 fractions) with concurrent chemotherapy, whereas the mean prescribed EBRT dose, including initial and boost doses to positive lymph nodes, ranged from 54 to 64 Gy. Afterwards, intracavitary(IC) or combined intracavitary/interstitial(IC/IS) brachytherapy was performed using a CT-based procedure with prescribed doses of 6 or 8 Gy in 3-7 fractions.

Results: The median follow-up time was 46 months. The 5-year local control, distant metastasis-free survival, and overall survival rates were 88.9%, 81.8%, 77.9%, respectively. IC/IS brachytherapy improved the HR-CTV D90 compared with IC (p<0.01). Seven patients (7.0%) had grade 2 bladder LSEs and none had grade 3/4 bladder LSEs. There was no significant relationship between bladder LSEs and the dose-volume histogram (p>0.05 for all). Thirty-seven patients (37%) had grade 2 rectal LSEs, 3(3%) had grade 3 rectal LSE. The rectum D1cc, D2cc, and D5cc values were significantly higher in patients with grades 2/3 rectal toxicity than in those with grades 0/1 (p<0.05 for all). There was no grade 2 and above small bowel LSEs.

Conclusions: CT-based brachytherapy planning can achieve excellent local control with acceptable morbidity. HR-CTV D90 can increase in the IC/IS group compared with the IC group. The D1cc, D2cc, and D5cc all showed excellent predictive values for rectal LSEs.

Keywords: cervical cancer, dose-volume histogram, brachytherapy, late side effects, computed tomography


Citation styles

APA
Dang, Y.Z., Li, P., Li, J.P., Bai, F., Zhang, Y., Mu, Y.F., Li, W.W., Wei, L.C., Shi, M. (2018). The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer. Journal of Cancer, 9(9), 1635-1641. https://doi.org/10.7150/jca.23974.

ACS
Dang, Y.Z.; Li, P.; Li, J.P.; Bai, F.; Zhang, Y.; Mu, Y.F.; Li, W.W.; Wei, L.C.; Shi, M. The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer. J. Cancer 2018, 9 (9), 1635-1641. DOI: 10.7150/jca.23974.

NLM
Dang YZ, Li P, Li JP, Bai F, Zhang Y, Mu YF, Li WW, Wei LC, Shi M. The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer. J Cancer 2018; 9(9):1635-1641. doi:10.7150/jca.23974. https://www.jcancer.org/v09p1635.htm

CSE
Dang YZ, Li P, Li JP, Bai F, Zhang Y, Mu YF, Li WW, Wei LC, Shi M. 2018. The Efficacy and Late Toxicities of Computed Tomography-based Brachytherapy with Intracavitary and Interstitial Technique in Advanced Cervical Cancer. J Cancer. 9(9):1635-1641.

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