Mahantshetty Umesh, Banerjee Susovan, Sturdza Alina, Kirisits Christian, Majercakova Katarina, Schmid Maximilian P, Hande Vinod, Pötter Richard
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India.
Division of Radiation Oncology, Medanta - The Medicity, Gurgaon, Haryana, India.
J Contemp Brachytherapy. 2021 Oct;13(5):512-518. doi: 10.5114/jcb.2021.110273. Epub 2021 Oct 25.
Clinical drawings are integral part of image-guided adaptive brachytherapy (IGABT) of cervical cancer. It was used in EMBRACE study protocol as a useful tool. In our study clinical drawings from EMBRACE study were modified to include scales in all the dimensions for more accurate representation of various tumor related volumes. The aim of the present study was to understand patterns of tumor regression and relationship between gross tumor at diagnosis (GTVD) and high-risk clinical target volume (CTV-T)/intermediate-risk clinical target volume (CTV-T) in brachytherapy (BRT), using modified clinical drawings.
42 cervical cancer patients, staged as FIGO IIB-IIIB according to EMBRACE study, were enrolled. Advanced schematic 3D mapping diagram (3D-MD) in axial, coronal, and sagittal orientations, with a measurement scale (grid with 10 mm distance) for precise assessment and documentation was applied (through MRI at diagnosis and during brachytherapy). Dimensions, including height, width, and thickness as well as volumes (GTVD, CTV-T and CTV-T) were compared both qualitatively and quantitatively.
We found qualitative and quantitative correlation of the dimensions of final CTV-T with initial GTVD. Meticulous mapping of tumor volumes can provide useful insights to CTV-T volume during brachytherapy.
临床绘图是宫颈癌图像引导自适应近距离放射治疗（IGABT）不可或缺的一部分。它在EMBRACE研究方案中被用作一种有用的工具。在我们的研究中，对EMBRACE研究中的临床绘图进行了修改，在所有维度上加入了比例尺，以便更准确地呈现各种肿瘤相关体积。本研究的目的是使用修改后的临床绘图，了解近距离放射治疗（BRT）中肿瘤退缩模式以及诊断时的大体肿瘤体积（GTVD）与高危临床靶区体积（CTV-T）/中危临床靶区体积（CTV-T）之间的关系。
纳入42例根据EMBRACE研究分期为FIGO IIB-IIIB期的宫颈癌患者。应用具有测量比例尺（间距为10 mm的网格）的轴向、冠状面和矢状面的高级示意图三维映射图（3D-MD），用于精确评估和记录（通过诊断时及近距离放射治疗期间的MRI）。对包括高度、宽度、厚度以及体积（GTVD、CTV-T和CTV-T）在内的维度进行了定性和定量比较。
我们发现最终CTV-T的维度与初始GTVD之间存在定性和定量相关性。肿瘤体积的精细映射可为近距离放射治疗期间的CTV-T体积提供有用的见解。
