Muramoto Yoichi, Murakami Naoya, Okonogi Noriyuki, Takatsu Jun, Iijima Kotaro, Inoue Tatsuya, Kato Kanade, Karino Tatsuki, Kojima Kanako, Oshima Masaki, Kosugi Yasuo, Kawamoto Terufumi, Hirayama Takashi, Fujino Kazunari, Terao Yasuhisa, Shikama Naoto
Department of Radiation Oncology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
Cancers (Basel). 2024 Jun 28;16(13):2384. doi: 10.3390/cancers16132384.
Analyzing dose distributions to regional lymph-node metastases (RLNMs) in locally advanced cervical cancer (LACC) patients undergoing intracavitary and interstitial hybrid brachytherapy (IC/IS).
Dose distributions of eleven LACC patients with 38 RLNMs, and who received 38 IC/IS sessions were analyzed in EQD, considering RLNM positions and ipsilateral interstitial needles; these RLNMs, excepting the para-aortic region, were classified into four groups.
RLNMs had a median of two ipsilateral interstitial needles per session. Significant differences were observed in total RLNM D, depending on whether the position was cranial or caudal of the uterine base (85.5 vs. 378.9 cGy, < 0.0001), and whether the RLNM D was associated with a number of ipsilateral interstitial needles between 0-1 or 2 or more (68.4 vs. 112.2 cGy, = 0.006) per session. At each session, Group 1 RLNMs (cranial of the uterine base, 0-1 ipsilateral interstitial needle) had a mean D of 21.1 cGy; Group 2 (cranial, 2 or more), 73.8; Group 3 (caudal, 0-1), 94.7; and Group 4 (caudal, 2 or more), 136.1.
RLNMs located caudal of the uterine base associated with two or more ipsilateral interstitial needles in IC/IS had a higher dose contribution, which should be considered when calculating the RLNMs' dose of external beam boost irradiation.
分析局部晚期宫颈癌（LACC）患者在接受腔内和组织间混合近距离放疗（IC/IS）时区域淋巴结转移灶（RLNM）的剂量分布。
对11例有38个RLNM且接受了38次IC/IS治疗的LACC患者的剂量分布进行等效剂量分析，考虑RLNM位置和同侧组织间针；除主动脉旁区域外，这些RLNM被分为四组。
每次治疗中RLNM同侧组织间针的中位数为两根。根据RLNM位于子宫底部的头侧还是尾侧（85.5 vs. 378.9 cGy，<0.0001），以及每次治疗中RLNM的剂量是否与同侧组织间针数量在0 - 1根或2根及以上有关（68.4 vs. 112.2 cGy，=0.006），观察到RLNM总剂量存在显著差异。每次治疗时，第1组RLNM（子宫底部头侧，0 - 1根同侧组织间针）的平均剂量为21.1 cGy；第2组（头侧，2根及以上）为73.8 cGy；第3组（尾侧，0 - 1根）为94.7 cGy；第4组（尾侧，2根及以上）为136.1 cGy。
在IC/IS治疗中，位于子宫底部尾侧且与两根或更多同侧组织间针相关的RLNM剂量贡献更高，在计算RLNM外照射剂量增强时应予以考虑。
