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BMC Cancer
Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer

Authors: Naoya Murakami, Takahiro Kasamatsu, Akihisa Wakita, Satoshi Nakamura, Hiroyoki Okamoto, Koji Inaba, Madoka Morota, Yoshinori Ito, Minako Sumi, Jun Itami

Published in: BMC Cancer | Issue 1/2014

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Abstract

Background

In this study, high risk clinical target volumes (HR-CTVs) according to GEC-ESTRO guideline were contoured retrospectively based on CT images taken at the time of high-dose rate intracavitary brachytherapy (HDR-ICBT) and correlation between clinical outcome and dose of HR-CTV were analyzed.

Methods

Our study population consists of 51 patients with cervical cancer (Stages IB-IVA) treated with 50 Gy external beam radiotherapy (EBRT) using central shield combined with 2–5 times of 6 Gy HDR-ICBT with or without weekly cisplatin. Dose calculation was based on Manchester system and prescribed dose of 6 Gy were delivered for point A. CT images taken at the time of each HDR-ICBT were reviewed and HR-CTVs were contoured. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (α/β = 10 Gy).

Results

Three-year overall survival, Progression-free survival, and local control rate was 82.4%, 85.3% and 91.7%, respectively. Median cumulative dose of HR-CTV D90 was 65.0 Gy (52.7-101.7 Gy). Median length from tandem to the most lateral edge of HR-CTV at the first ICBT was 29.2 mm (range, 18.0-51.9 mm). On univariate analysis, both LCR and PFS was significantly favorable in those patients D90 for HR-CTV was 60 Gy or greater (p = 0.001 and 0.03, respectively). PFS was significantly favorable in those patients maximum length from tandem to edge of HR-CTV at first ICBT was shorter than 3.5 cm (p = 0.042).

Conclusion

Volume-dose showed a relationship to the clinical outcome in CT based brachytherapy for cervical carcinoma.
Appendix
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Metadata
Title
CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer
Authors
Naoya Murakami
Takahiro Kasamatsu
Akihisa Wakita
Satoshi Nakamura
Hiroyoki Okamoto
Koji Inaba
Madoka Morota
Yoshinori Ito
Minako Sumi
Jun Itami
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-447

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