Purpose: To evaluate the associations for vaginal dose points of vaginal stricture in image-guided brachytherapy. Materials and Methods: Twenty-six patients of locally advanced cervical cancer were treated with Image-...Purpose: To evaluate the associations for vaginal dose points of vaginal stricture in image-guided brachytherapy. Materials and Methods: Twenty-six patients of locally advanced cervical cancer were treated with Image-Guided Brachytherapy (IGBT) with the dose at least 7 Gy per fraction to the D90 of High-Risk Clinical Target Volume (HR-CTV). The vaginal dose points of recommendations of the American Brachytherapy Society (ABS) were added into the plan and cumulative dose to these points was evaluated in Equivalent Dose of 2 Gy (EQD2) concepts. Results: The mean doses to right vaginal dose point (VR), left vaginal dose point (VL) and average dose of VR/VL ((VR + VL)/2) were 101.5 Gy, 98.2 Gy and 99.8 Gy in EQD2 concepts, respectively. Volume-based planning significantly reduced the cumulative dose in EQD2 concepts at vaginal points. At the median follow-up time of 22 months, grade-2 vaginal stricture was observed in two patients. The incidences of vaginal stricture were not differed between the cumulative dose to vaginal dose points in EQD2 concepts of ≤90 Gy versus >90 Gy (P = 1.000) and ≤100 Gy versus >100 Gy (P = 0.815). Conclusion: No association for cumulative vaginal doses and events of vaginal stricture was found.展开更多
Background: There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating inter...Background: There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage I EC using in-house made multi-channel applicators (IH-MCA) in a single institution. Methods: Three hundred and ninety patients with stage I IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015. All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT). The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT. Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment. The Kaplan-Meier method was used to calculate survival rate. Results: Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4–172 months). The 5-year overall survival (OS), progression-free survival, local recurrence, and distant metastasis rates for all patients were 96.3%, 92.1%, 2.9%, and 4.8% respectively. Two patients had isolated relapse in vagina outside the irradiated volume. The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio: 0.368, 95% confidence interval [CI]: 0.131–1.035, P = 0.048;hazard ratio: 0.576, 95% CI: 0.347–0.958, P = 0.026,). Conclusions: For patients with IR to HR stage I EC, adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates. Age and grade were the prognostic factors correlated with OS.展开更多
文摘Purpose: To evaluate the associations for vaginal dose points of vaginal stricture in image-guided brachytherapy. Materials and Methods: Twenty-six patients of locally advanced cervical cancer were treated with Image-Guided Brachytherapy (IGBT) with the dose at least 7 Gy per fraction to the D90 of High-Risk Clinical Target Volume (HR-CTV). The vaginal dose points of recommendations of the American Brachytherapy Society (ABS) were added into the plan and cumulative dose to these points was evaluated in Equivalent Dose of 2 Gy (EQD2) concepts. Results: The mean doses to right vaginal dose point (VR), left vaginal dose point (VL) and average dose of VR/VL ((VR + VL)/2) were 101.5 Gy, 98.2 Gy and 99.8 Gy in EQD2 concepts, respectively. Volume-based planning significantly reduced the cumulative dose in EQD2 concepts at vaginal points. At the median follow-up time of 22 months, grade-2 vaginal stricture was observed in two patients. The incidences of vaginal stricture were not differed between the cumulative dose to vaginal dose points in EQD2 concepts of ≤90 Gy versus >90 Gy (P = 1.000) and ≤100 Gy versus >100 Gy (P = 0.815). Conclusion: No association for cumulative vaginal doses and events of vaginal stricture was found.
文摘Background: There are only very few reports on clinical outcomes using multi-channel applicators (MCA) for patients with endometrial cancer (EC) in China. We aimed to evaluate the clinical experience of treating intermediate-risk (IR) to high-risk (HR) stage I EC using in-house made multi-channel applicators (IH-MCA) in a single institution. Methods: Three hundred and ninety patients with stage I IR to HR EC were treated with hysterectomy and adjuvant radiotherapy from 2003 to 2015. All patients received post-operative vaginal cuff brachytherapy (VBT) alone or as a boost after external beam radiotherapy (EBRT). The prescriptions were 500 cGy per fraction for a total of 5 to 6 fractions with brachytherapy alone or 400 to 600 cGy per fraction for 2 to 3 fractions if it was combined with EBRT. Two types of applicators including a traditional rigid IH-MCA and a recent model custom-made with 3 dimension printing technology were used for treatment. The Kaplan-Meier method was used to calculate survival rate. Results: Follow-up rate was 92.8% and the median follow-up time was 48 months (range 4–172 months). The 5-year overall survival (OS), progression-free survival, local recurrence, and distant metastasis rates for all patients were 96.3%, 92.1%, 2.9%, and 4.8% respectively. Two patients had isolated relapse in vagina outside the irradiated volume. The univariate and multivariate analysis showed that age and grade were the prognostic factors correlated with OS (hazard ratio: 0.368, 95% confidence interval [CI]: 0.131–1.035, P = 0.048;hazard ratio: 0.576, 95% CI: 0.347–0.958, P = 0.026,). Conclusions: For patients with IR to HR stage I EC, adjuvant VBT alone or in combination with EBRT using IH-MCA led to excellent survival and recurrence rates. Age and grade were the prognostic factors correlated with OS.
