Moghani Mona Malekzadeh, Siavashpour Zahra, Ogorodniitchouk Oleksander, Moreno-Acosta Pablo, Plattard Delphine, Vallard Alexis, Sotton Sandrine, Bouleftour Wafa, Langrand-Escure Julien, Magné Nicolas
Department of Radiation-Oncology, Shohadaye Tajrish Educational Hospital, Shahid Beheshti University of Medical Sciences, Teheran, Iran.
Department of Radiotherapy, Lucien Neuwirth Cancer Institute, Saint-Etienne, France.
J Contemp Brachytherapy. 2022 Apr;14(2):183-188. doi: 10.5114/jcb.2022.115330. Epub 2022 Apr 6.
The present study aimed to assess the correlation between dose to pelvic lymph nodes and to point B with tandem-ring (TR) applicators for intra-cavitary brachytherapy treatment of locally advanced cervical cancer.
Cervical cancer patients treated at brachytherapy department of Lucien Neuwirth Cancer Center, from 2015 to 2018, were included. Target delineation was performed in compliance with GEC-ESTRO guidelines. Revised American Brachytherapy Society (ABS) point A was determined (A (right) and A (left)) as well as Manchester point B. Prescription dose was 25-35 Gy in 5 fractions. Pelvic lymph nodes were delineated, then dose to points A and B, and dose-volume histogram (DVH) parameters of delineated lymph nodes were extracted. Significant relationships or correlations between lymph nodes reference points, dosage to points B, and their DVH parameters were investigated.
The mean dose and mean percentage of the prescription dose to the left and right points B were 4.6 ±0.18 Gy and 82.08 ±0.72%, respectively. Pearson correlation coefficient = 0.81 (-value = 0.00) between dose to A and A points and prescription dose was obtained. Negative correlation between CTV volume and difference between French and ABS prescription points was found.
Dose to point B can be a moderate surrogate for maximum, minimum, and median dose to the internal iliac and presacral lymph node, but cannot be for maximum dose to the obturator lymph node. Points B cannot be a reliable substitute for common and external iliac chains.
本研究旨在评估在腔内近距离放射治疗局部晚期宫颈癌时，使用串联环（TR）施源器时盆腔淋巴结和B点剂量之间的相关性。
纳入2015年至2018年在吕西安·纽维尔特癌症中心近距离放射治疗科接受治疗的宫颈癌患者。靶区勾画按照GEC-ESTRO指南进行。确定修订后的美国近距离放射治疗学会（ABS）A点（A（右）和A（左））以及曼彻斯特B点。处方剂量为25 - 35 Gy，分5次给予。勾画盆腔淋巴结，然后提取A点和B点的剂量以及勾画淋巴结的剂量体积直方图（DVH）参数。研究淋巴结参考点、B点剂量及其DVH参数之间的显著关系或相关性。
左右B点的平均剂量和处方剂量的平均百分比分别为4.6±0.18 Gy和82.08±0.72%。A点和A'点剂量与处方剂量之间的Pearson相关系数为0.81（P值 = 0.00）。发现CTV体积与法国和ABS处方点之间的差异呈负相关。
B点剂量可作为髂内和骶前淋巴结最大、最小和中位剂量的适度替代指标，但不能作为闭孔淋巴结最大剂量的替代指标。B点不能可靠替代总髂血管链和髂外血管链。
