Department of Oncology, Hebei General Hospital, 348 West Heping Road, Shijiazhuang, Hebei, 050051, China.
Radiat Oncol. 2024 Jun 8;19(1):70. doi: 10.1186/s13014-024-02454-1.
To investigate the efficacy of I seed brachytherapy for non-central pelvic recurrence of cervical cancer after external beam radiotherapy, and to analyze the clinical influential factors.
Between June 2015 and April 2022, 32 patients with 41 lesions were treated with I seed brachytherapy. The seeds were implanted under the guidance of CT and/or 3D-printed template images at a median dose of 100 Gy (range, 80-120 Gy), and the local control rate (LCR) and survival rates were calculated. We used multivariate logistic regression to identify prognosis predictors, and receiver operating characteristic (ROC) curve analysis to determine the optimal cut-off values.
The median follow-up was 48.52 months (range, 4-86 months), and the 6-, 12-, and 24-month LCR was 88.0%, 63.2%, and 42.1%, respectively. The 1- and 2-year survival rates were 36% and 33%, respectively, and the median survival time was 13.26 months. No significant adverse events occurred. Multivariate regression analysis showed that tumor diameter, tumor stage, and LCR were independent factors influencing survival. ROC curve analysis showed that the area under the curve for tumor diameter and D90 were 0.765 and 0.542, respectively, with cut-off values of 5.3 cm and 108.5 Gy.
The present findings indicate that I seed brachytherapy is feasible for treating non-central pelvic recurrence of cervical cancer after external beam radiotherapy. Further, tumor diameter < 5.3 cm and immediate postoperative D90 > 108.5 Gy were associated with better efficacy.
探讨 ¹²⁵I 籽源近距离放疗治疗宫颈癌根治性放疗后非中央型盆腔复发的疗效，并分析其临床影响因素。
2015 年 6 月至 2022 年 4 月，对 32 例 41 处病灶的患者行 ¹²⁵I 籽源近距离放疗。在 CT 和/或 3D 打印模板图像引导下植入种子，中位剂量为 100 Gy（范围 80-120 Gy），计算局部控制率（LCR）和生存率。采用多因素 logistic 回归分析确定预后预测因素，采用受试者工作特征（ROC）曲线分析确定最佳截断值。
中位随访时间为 48.52 个月（范围 4-86 个月），6、12 和 24 个月的 LCR 分别为 88.0%、63.2%和 42.1%。1 年和 2 年生存率分别为 36%和 33%，中位生存时间为 13.26 个月。无明显不良反应。多因素回归分析显示，肿瘤直径、肿瘤分期和 LCR 是影响生存的独立因素。ROC 曲线分析显示，肿瘤直径和 D90 的曲线下面积分别为 0.765 和 0.542，截断值分别为 5.3 cm 和 108.5 Gy。
¹²⁵I 籽源近距离放疗治疗宫颈癌根治性放疗后非中央型盆腔复发是可行的。此外，肿瘤直径＜5.3 cm 和术后即刻 D90＞108.5 Gy 与更好的疗效相关。
