- 作者：Petra Georg ; M.D.&lowast ; ; petra.georg@akhwien.at ; Richard Pö ; tter ; M.D.&lowast ; ; Dietmar Georg ; Ph.D.&lowast ; ; Stefan Lang ; Ph.D.&lowast ; ; Johannes C.A. Dimopoulos ; M.D.&lowast ; ; Alina E. Sturdza ; M.D.&lowast ; ; Daniel Berger ; Ph.D.&lowast ; ; Christian Kirisits ; D.Sc.&lowast ; ; Wolfgang Dö ; rr ; D.V.M. ; Ph.D.&lowast ; ; &dagger ;
- 关键词：Adaptive brachytherapy ; Cervix cancer ; Late side effects ; Magnetic resonance
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 February 2012
- 年：2012
- 卷：82
- 期：2
- 页码：653-657
- 全文大小：145 K
Purpose
To establish dose-response relationships for late side effects of the rectum and bladder in cervix cancer patients after magnetic resonance image-guided adaptive brachytherapy (IGABT).Methods and Materials
A cohort of 141 patients was treated with 45 to 50.4 Gy with or without cisplatin plus 4 fractions of 7 Gy IGABT. Doses for the most exposed 2, 1, and 0.1-cm3 (D2cc, D1cc, D0.1cc) volumes of the rectum and bladder were converted into the equivalent dose in 2 Gy fractions (EQD2), using a linear quadratic model (¦Á/¦Â?= 3 Gy). Late side effects were prospectively assessed (using late effects in normal tissues subjective, objective, management and analytic [LENT SOMA]) scales. Dose-response relationships were determined by logit analyses.
Results
Eleven patients developed rectal side effects, and 23 patients had urinary side effects. A significant dose effect was found for all rectal dose-volume histogram (DVH) parameters for patients with side effect grades of 1 to 4 but was only significant for D2cc and D1cc for grades ?. The ED10 values for D2cc were 73 Gy for grades 1 to 4 and 78 Gy for grades 2 to 4 rectal morbidity. For bladder side effects, a significant dose effect was shown for all DVH parameters for complication grades ?; the respective ED10 was 101 Gy.
Conclusions
Well-defined dose-response curves could be established for D2cc in the rectum and the urinary bladder.