Wu Ning, Zhao Zhipeng, Han Dongmei, Cheng Guanghui, Zhao Hongfu
Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun, China.
J Radiat Res. 2019 Jan 1;60(1):124-133. doi: 10.1093/jrr/rry088.
The present study aimed to compare the dosages of target regions and organs at risk (OARs) in 3D intracavitary brachytherapy (ICBT) and conventional 2D ICBT for Chinese patients with cervical carcinoma. ICBT was performed in a total of 66 patients with Stage IB to IVA cervical carcinoma who had not received surgery but who had received whole-pelvic external-beam radiotherapy (EBRT). Plans for the 3D-ICBT and the conventional 2D-ICBT were individually designed for every patient. The dosages differences between the target regions and the OARs in patients with each of the various stages of cervical carcinoma were compared between the two ICBT plans. There was no significant difference in the dose at Point A between the two ICBT plans. However, the CTVhr-D90, CTVhr-D100 and CTVir-D90 in 3D-ICBT were much higher than in 2D-ICBT, especially in Stage IIB (P < 0.05). As compared with conventional 2D-ICBT, the dosages of DICRU and D2.0cm3 in the rectum/bladder, and D2.0cm3 in the sigmoid/small bowel were decreased significantly in 3D-ICBT (P < 0.05). For patients with Stage IIA, IIB and IIIB, the D2.0cm3 in the rectum/bladder was significantly reduced in 3D-ICBT (P < 0.05). It was demonstrated that, in Chinese patients, 3D-ICBT for cervical carcinoma could optimize the target coverage and reduce the dosages to the OARs compared with conventional 2D-ICBT.
本研究旨在比较三维腔内近距离放射治疗(ICBT)与传统二维ICBT对中国宫颈癌患者靶区及危及器官(OARs)的剂量。共有66例IB至IVA期宫颈癌患者接受了ICBT,这些患者未接受手术,但接受了全盆腔外照射放疗(EBRT)。为每位患者分别设计了三维ICBT和传统二维ICBT计划。比较了两种ICBT计划下各期宫颈癌患者靶区与OARs之间的剂量差异。两种ICBT计划在A点的剂量无显著差异。然而,三维ICBT中的CTVhr-D90、CTVhr-D100和CTVir-D90远高于二维ICBT,尤其是在IIB期(P<0.05)。与传统二维ICBT相比,三维ICBT中直肠/膀胱的DICRU和D2.0cm3剂量以及乙状结肠/小肠的D2.0cm3剂量显著降低(P<0.05)。对于IIA、IIB和IIIB期患者,三维ICBT中直肠/膀胱的D2.0cm3剂量显著降低(P<0.05)。结果表明,在中国患者中,与传统二维ICBT相比,宫颈癌三维ICBT可优化靶区覆盖并降低OARs的剂量。