Definitive radiotherapy consisting of whole pelvic radiotherapy with no central shielding and CT-based intracavitary bra
- PDF / 624,875 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 47 Downloads / 138 Views
ORIGINAL ARTICLE
Definitive radiotherapy consisting of whole pelvic radiotherapy with no central shielding and CT‑based intracavitary brachytherapy for cervical cancer: feasibility, toxicity, and oncologic outcomes in Japanese patients Takeaki Kusada1 · Takafumi Toita2 · Takuro Ariga1 · Wataru Kudaka3 · Hitoshi Maemoto1 · Wataru Makino1 · Kazuki Ishikawa1 · Joichi Heianna1 · Yutaka Nagai4 · Yoichi Aoki3 · Sadayuki Murayama1 Received: 26 April 2020 / Accepted: 23 June 2020 © The Author(s) 2020
Abstract Background This prospective study investigated the feasibility, toxicity, and oncologic outcomes of definitive radiotherapy (RT) consisting of whole pelvic radiotherapy with no central shielding (noCS-WPRT) and CT-based intracavitary brachytherapy (ICBT) in Japanese patients with cervical cancer. Methods Patients with cervical cancer of FIGO stages IB1–IVA were eligible. The treatment protocol consisted of noCSWPRT of 45 Gy in 25 fractions and CT-based high dose-rate ICBT of 15 or 20 Gy in 3 or 4 fractions prescribed at point A. The prescribed ICBT dose was decreased if the manual dwell time/position optimization failed to meet organs-at-risk constraints. Graphical optimization and additional interstitial needles were not applied. Results We enrolled 40 patients. FIGO stages were IB1: 11, IB2: 13, IIA2: 1, IIB: 11, IIIB: 3, and IVA: 1. Median (range) pretreatment tumor diameter was 47 (14–81) mm. Point A doses were decreased in 19 of 153 ICBT sessions (12%). The median follow-up duration was 33 months. The 2-year rates of pelvic control, local control (LC), and progression-free survival were 83%, 85%, and 75%, respectively. Pre-ICBT tumor diameter, high-risk clinical target volume (HR-CTV), total HR-CTV D90, and overall treatment time (OTT) significantly affected LC. Late adverse events (grade ≥ 3) were observed in 3 patients (2 in the bladder, 1 in the rectum). Conclusions Definitive RT consisting of noCS-WPRT and CT-based ICBT was feasible for Japanese patients with cervical cancer. To further improve LC, additional interstitial needles for patients with a large HR-CTV and shorter OTT should be considered. Keywords Cervix neoplasms · Radiotherapy · Brachytherapy
Introduction * Takafumi Toita [email protected] 1
Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903‑0215, Japan
2
Radiation Therapy Center, Okinawa Chubu Hospital, 281 Miyazato, Uruma, Okinawa 904‑2293, Japan
3
Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903‑0215, Japan
4
Department of Obstetrics and Gynecology, Nanbu Medical Center/Nanbu Child Medical Center, 118‑1 Arakawa, Shimajiri, Okinawa 901‑1193, Japan
Definitive radiotherapy (RT) and/or concurrent chemoradiotherapy (CCRT) consisting of external beam radiation therapy (EBRT) and intracavitary brachytherapy (ICBT) is the standard treatment of choice for patients with stage IB to IVA uterine cervical cancer [1].
Data Loading...
