- 作者：Akila N. Viswanathan ; M.D. ; M.P.H.&lowast ; ; aviswanathan@lroc.harvard.edu ; Carien L. Creutzberg ; M.D. ; Ph.D.&dagger ; ; Peter Craighead ; M.B. ; Ch.B.&Dagger ; ; Mary McCormack ; FRCR Ph.D.§ ; ; Takafumi Toita ; M.D.¶ ; ; Kailash Narayan ; M.D. ; Ph.D.?/sup> ; Nicholas Reed ; M.B.B.S.&lowast ; &lowast ; ; Harry Long ; M.D.&dagger ; &dagger ; ; Hak-Jae Kim ; M.D.&Dagger ; &Dagger ; ; Christian Marth ; M.D.§ ; § ; ; Jacob C. Lindegaard ; M.D.¶ ; ¶ ; ; Annmarie Cerrotta ; M.D.¡¬?/sup> ; William Small Jr. ; M.D.&lowast ; &lowast ; &lowast ; ; Edward Trimble ; M.D. ; M.P.H.&dagger ; &dagger ; &dagger ;
- 关键词：Brachytherapy ; Cervical cancer ; Radiation dose
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 出版时间：1 January 2012
- 年：2012
- 卷：82
- 期：1
- 页码：250-255
- 全文大小：194 K
Purpose
To determine current practice patterns with regard to gynecologic high-dose-rate (HDR) brachytherapy among international members of the Gynecologic Cancer Intergroup (GCIG) in Japan/Korea (Asia), Australia/New Zealand (ANZ), Europe (E), and North America (NAm).Methods and Materials
A 32-item survey was developed requesting information on brachytherapy practice patterns and standard management for Stage IB¨CIVA cervical cancer. The chair of each GCIG member cooperative group selected radiation oncology members to receive the survey.
Results
A total of 72 responses were analyzed; 61 respondents (85 % ) used HDR. The three most common HDR brachytherapy fractionation regimens for Stage IB¨CIIA patients were 6 Gy for five fractions (18 % ), 6 Gy for four fractions (15 % ), and 7 Gy for three fractions (11 % ); for Stage IIB¨CIVA patients they were 6 Gy for five fractions (19 % ), 7 Gy for four fractions (8 % ), and 7 Gy for three fractions (8 % ). Overall, the mean combined external-beam and brachytherapy equivalent dose (EQD2) was 81.1 (standard deviation [SD] 10.16). The mean EQD2 recommended for Stage IB¨CIIA patients was 78.9 Gy (SD 10.7) and for Stage IIB¨CIVA was 83.3 Gy (SD 11.2) (p = 0.02). By region, the mean combined EQD2 was as follows: Asia, 71.2 Gy (SD 12.65); ANZ, 81.18 (SD 4.96); E, 83.24 (SD 10.75); and NAm, 81.66 (SD, 6.05; p = 0.02 for Asia vs. other regions).The ratio of brachytherapy to total prescribed dose was significantly higher for Japan (p = 0.0002).
Conclusion
Although fractionation patterns may vary, the overall mean doses administered for cervical cancer are similar in Australia/New Zealand, Europe, and North America, with practitioners in Japan administering a significantly lower external-beam dose but higher brachytherapy dose to the cervix. Given common goals, standardization should be possible in future clinical trials.