Impact of dosimetric parameters on local control for patients treated with three-dimensional pulsed dose-rate brachytherapy for cervical cancer

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• 作者：Sabrina Boyrie¹ ; ^{boyrie.sabrina@claudiusregaud.fr" class="auth_mail} ; Claire Charra-Brunaud² ; Valentin Harter³ ; Anne Ducassou¹ ; Youlia Kirova⁴ ; Isabelle Barillot⁵ ; Claude Krzisch⁶ ; Philippe Lang⁷ ; Marie-Hé ; lè ; ne Baron⁸ ; Xavier Montbarbon⁹ ; Martine Delannes¹ ; Didier Peiffert²
• 关键词：Cervical cancer ; Three-dimensional brachytherapy ; Pulsed dose-rate brachytherapy ; Local control
• 刊名：Brachytherapy
• 出版年：July-August 2014
• 年：2014
• 卷：13
• 期：4
• 页码：326-331
• 全文大小：233 K

文摘

To investigate the impact of dose-volume histograms parameters on local control of three-dimensional (3D) image-based pulsed dose-rate brachytherapy (BT).

Methods and Materials

Within a French multicentric prospective study, the data of the 110 patients treated for cervical cancer with external beam radiotherapy followed by 3D image-based and optimized pulsed dose-rate BT were analyzed. Delineation procedures were performed on magnetic resonance imaging in a minority of cases and on CT for the majority of cases, adapted from the Gynaecological Groupe Européen de Curiethérapie—European Society for Therapeutic Radiology and Oncology recommendations. Optimization procedure was left to the discretion of the treating center.

Results

At 2 years, local control rate reached 78%. Dose to Point A, total reference air kerma, and intermediate-risk clinical target volume (IR-CTV) V₆₀ were predictive factors for local control (p = 0.001, p = 0.001, and p = 0.013, respectively). Patients with IR-CTV V₆₀ <75% had a relative risk of local recurrence of 3.8 (95% confidence interval, 1.4–11.1). There was no correlation found between the high-risk clinical target volume dosimetric parameters and local control.

Conclusions

This multicentric study has shown that 3D image-based BT provides a high local control rate for cervical cancer patients. The V₆₀ for IR-CTV was identified as an important predictive factor for local control.