Marjanovic Dragoslava, Plesinac Karapandzic Vesna, Stojanovic Rundic Suzana, Tomasevic Aleksandar, Saric Milan, Miskovic Ivana, Nidzovic Borko, Mikovic Mirjana, Petrasinovic Predrag
Department of Radiotherapy, Institute for Oncology and Radiology of Serbia, Belgrade, Serbia.
J BUON. 2019 Sep-Oct;24(5):2028-2034.
PURPOSE: Within implementation of intensity-modulated radiotherapy (IMRT) in the postoperative irradiation of cervical cancer we evaluated and compared IMRT and three-dimensional conformal radiotherapy (3DCRT) dosimetric parameters for target volumes and organs at risk (OAR). METHODS: We randomized 95 patients with cervical cancer, UICC stage I-III, in groups depending of the type of external beam postoperative radiotherapy. Forty-five patients were treated with IMRT and 50 with 3DCRT. All patients underwent brachytherapy, and according to risk factors some of the patients had concomitant cisplatin chemotherapy. The study was done in a period of three years from December 2015. Analysis of dosimetric parameters for target volume coverage and OARs was performed. RESULTS: IMRT plans showed better conformity compared to 3DCRT plans, represented with homogenity index and conformity index, with higher maximum dose (PTV105 and D2). Both plans achieved adequate planning target volume coverage described with PTV95. Statistically significant difference between groups was found for bladder, rectum and bowel high dose regions: bladder V45 (p=0.000), rectum V40 (p=0.043) and V45 (p=0.000), bowel V45 (p=0.000), and bone marrow dosimetric parameters V20-V45; all were better in IMRT plans. Significant difference was found for volume of patient body normal tissue receiving dose of 20Gy, which was higher in IMRT. CONCLUSION: IMRT is a highly conformal technique. Satisfactory target volume coverage was achieved with both techniques, with better sparing of OARs in the IMRT group. With this technique improvement, we expect better quality of life in cervical cancer patients with good prognosis.
目的:在宫颈癌术后放疗中实施调强放疗(IMRT)时,我们评估并比较了IMRT与三维适形放疗(3DCRT)针对靶区和危及器官(OAR)的剂量学参数。 方法:我们将95例国际妇产科联盟(UICC)I - III期宫颈癌患者根据术后外照射放疗类型分组进行随机化。45例患者接受IMRT治疗,50例接受3DCRT治疗。所有患者均接受近距离放疗,部分患者根据危险因素接受顺铂同步化疗。该研究于2015年12月起的三年时间内完成。对靶区覆盖和OAR的剂量学参数进行了分析。 结果:与3DCRT计划相比,IMRT计划显示出更好的适形性,以均匀性指数和适形性指数表示,且最大剂量更高(PTV105和D2)。两种计划均实现了以PTV95描述的足够的计划靶区覆盖。在膀胱、直肠和肠道高剂量区域发现两组间存在统计学显著差异:膀胱V45(p = 0.000)、直肠V40(p = 0.043)和V45(p = 0.000)、肠道V45(p = 0.000)以及骨髓剂量学参数V20 - V45;在IMRT计划中这些参数均更好。接受20Gy剂量的患者身体正常组织体积存在显著差异,IMRT组更高。 结论:IMRT是一种高度适形的技术。两种技术均实现了令人满意的靶区覆盖,IMRT组对OAR的保护更好。随着这项技术的改进,我们期望预后良好的宫颈癌患者生活质量得到提高。
Nan Fang Yi Ke Da Xue Xue Bao. 2012-8
Cochrane Database Syst Rev. 2022-8-22