Background: Treatment of Cervical cancer includes a combination of external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT). ICBT helps to boost radiation dose to primary disease. Organs like rectum, ...Background: Treatment of Cervical cancer includes a combination of external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT). ICBT helps to boost radiation dose to primary disease. Organs like rectum, bladder, sigmoid and small bowel lie close to the cervix region and these organs receive dose from EBRT as well as ICBT and we want to know the dose to these organ at risk (OAR). Materials & Methods: Dosimetric details of 174 ICBT applications done in 58 patients were retrospectively analysed. All patients received EBRT dose of 50.4 Gy in 28 fractions. All patients had ICBT, three sessions with 7 Gy prescribed to point A. Dosimetric data including dose to right and left point A and dose to OARs were recorded from Oncentra Planning System. Results: Mean dose to point A on right side was 6.89 Gy and left side was 6.91 Gy. Mean D2cc dose to rectum, bladder, sigmoid and small bowel was 3.5 Gy, 5.25 Gy, 4.75 Gy and 4.2 Gy respectively. Mean EQD2 dose combining EBRT and ICBT in point A was 78.7 Gy on right side and 79 Gy on left side. Mean EQD2 doses to D2cc of rectum, bladder, sigmoid and small bowel was 62 Gy, 74.4 Gy, 70.5 Gy and 66.5 Gy respectively. Conclusion: From the results of this dosimetric study it is evident that OARs like rectum, sigmoid, bladder & bowel are receiving only acceptable doses of radiation using point A prescribed CT based ICBT planning. Hence with regards to OAR doses, CT based ICBT planning with dose prescribed to point A is a feasible option.展开更多
OBJECTIVE To observe the curative effects and complications of californium-252 (252Cf) neutron intraluminal brachytherapy (IBT) combined with external irradiation (El) for treatment of cervical carcinoma. METHODS From...OBJECTIVE To observe the curative effects and complications of californium-252 (252Cf) neutron intraluminal brachytherapy (IBT) combined with external irradiation (El) for treatment of cervical carcinoma. METHODS From December 2000 to December 2004, 128 cases of cervical carcinoma staged intoⅡA-ⅢB according to the International Federation of Gynecology and Obstetrics (FIGO) standards were treated with 2S2Cf neutron IBT using 8-10 Gy per fraction, once a week. The total dose at reference A point was 36-40 Gy in 4-5 fractions. From the second day after 252Cf neutron IBT treatment, the whole pelvic cavity was treated with 60Coγ-ray El, applying 2 Gy per fraction, 4 times per week. After 20-25 Gy of El, the center of the whole pelvic field was blocked with 4 cm of lead in width. The total dose of El was 45-50 Gy. RESULTS The short-term therapeutic effects were CR 95.3% and PR 4.7%. The 3 and 5-year local control rates were 93.5% and 87.9%. The overall 3-year survival rate was 87.5% and for StagesⅡandⅢ, 90.9% and 81.5% respectively; the overall 5-year survival rate was 70% and for StagesⅡandⅢ, 76.2% and 61% respectively. The rate of radiation complications was 4.7% for radiation cystitis, 7.8% for radiation proctitis, 6.3% for vagina contracture and adhesion and 5.5% for protracted radiation proctitis. CONCLUSION An combination of 252Cf neutron IBT with El for treatment of cervical carcinoma can be well -tolerated by cervical carcinoma patients. The rate of local tumor control is high and radiation complications are few.展开更多
Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we inves...Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.展开更多
OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma (NPC) treated with combined external-beam radiotherapy (EBR) and intracavitary brachytherapy (IB) using a new-type applicato...OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma (NPC) treated with combined external-beam radiotherapy (EBR) and intracavitary brachytherapy (IB) using a new-type applicator. METHODS Eighty patients with untreated NPC were divided into two groups based on therapy methods. An experimental group was treated with EBR plus IB and a control group was treated only with EBR. IB was given to the patients of the experimental group when the external radiotherapy dose amounted to more than 60～65 Gy. The total dose of IB was 6～20 Gy and the total dose of EBR of the control group was 70～75 Gy. RESULTS Follow-up was conducted for 97.5% of the patients with results as follows: the overall response rates (ORR) for the experimental and the control groups were 92.5% and 75.3% respectively (P<0.05); the 3 and 5-year survival rates for the experimental group were 87.5% and 74.2% and for the control group, 65.0% and 55.6% (P<0.05); for the experimental group, the 3 and 5-year disease-free survival rates were 72.5% and 64.5% and for the control group, 60.0% and 52.8% (P>0.05).Some complications following radiotherapy showed a signi fi cant difference. CONCLUSION External irradiation plus intracavitary brachytherapy using a new-type applicator may improve the ORR and survival rates, reduce radiation complications and increase the quality of life.展开更多
目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按...目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按照施源器的不同分成2个组,每组36次,对靶区剂量、危及器官等进行比较。结果:在给予A点相同处方剂量的情况下,HR-CTV D90、D100在三管式腔内后装组与腔内结合组织间插植后装组中分别为(590.0±46.4)cGy、(471.2±66.2)cGy,(502.8±67.7)cGy、(335.9±46.0)cGy,P<0.05),膀胱、直肠、乙状结肠D2cc均相近(P=0.85、0.28、0.53)。结论:采用腔内结合插植后装治疗局部晚期宫颈癌比三管式腔内后装可获得更高的靶区剂量,但长期疗效及晚期反应仍需进一步研究。展开更多
文摘Background: Treatment of Cervical cancer includes a combination of external beam radiotherapy (EBRT) with intracavitary brachytherapy (ICBT). ICBT helps to boost radiation dose to primary disease. Organs like rectum, bladder, sigmoid and small bowel lie close to the cervix region and these organs receive dose from EBRT as well as ICBT and we want to know the dose to these organ at risk (OAR). Materials & Methods: Dosimetric details of 174 ICBT applications done in 58 patients were retrospectively analysed. All patients received EBRT dose of 50.4 Gy in 28 fractions. All patients had ICBT, three sessions with 7 Gy prescribed to point A. Dosimetric data including dose to right and left point A and dose to OARs were recorded from Oncentra Planning System. Results: Mean dose to point A on right side was 6.89 Gy and left side was 6.91 Gy. Mean D2cc dose to rectum, bladder, sigmoid and small bowel was 3.5 Gy, 5.25 Gy, 4.75 Gy and 4.2 Gy respectively. Mean EQD2 dose combining EBRT and ICBT in point A was 78.7 Gy on right side and 79 Gy on left side. Mean EQD2 doses to D2cc of rectum, bladder, sigmoid and small bowel was 62 Gy, 74.4 Gy, 70.5 Gy and 66.5 Gy respectively. Conclusion: From the results of this dosimetric study it is evident that OARs like rectum, sigmoid, bladder & bowel are receiving only acceptable doses of radiation using point A prescribed CT based ICBT planning. Hence with regards to OAR doses, CT based ICBT planning with dose prescribed to point A is a feasible option.
文摘OBJECTIVE To observe the curative effects and complications of californium-252 (252Cf) neutron intraluminal brachytherapy (IBT) combined with external irradiation (El) for treatment of cervical carcinoma. METHODS From December 2000 to December 2004, 128 cases of cervical carcinoma staged intoⅡA-ⅢB according to the International Federation of Gynecology and Obstetrics (FIGO) standards were treated with 2S2Cf neutron IBT using 8-10 Gy per fraction, once a week. The total dose at reference A point was 36-40 Gy in 4-5 fractions. From the second day after 252Cf neutron IBT treatment, the whole pelvic cavity was treated with 60Coγ-ray El, applying 2 Gy per fraction, 4 times per week. After 20-25 Gy of El, the center of the whole pelvic field was blocked with 4 cm of lead in width. The total dose of El was 45-50 Gy. RESULTS The short-term therapeutic effects were CR 95.3% and PR 4.7%. The 3 and 5-year local control rates were 93.5% and 87.9%. The overall 3-year survival rate was 87.5% and for StagesⅡandⅢ, 90.9% and 81.5% respectively; the overall 5-year survival rate was 70% and for StagesⅡandⅢ, 76.2% and 61% respectively. The rate of radiation complications was 4.7% for radiation cystitis, 7.8% for radiation proctitis, 6.3% for vagina contracture and adhesion and 5.5% for protracted radiation proctitis. CONCLUSION An combination of 252Cf neutron IBT with El for treatment of cervical carcinoma can be well -tolerated by cervical carcinoma patients. The rate of local tumor control is high and radiation complications are few.
文摘Currently, image-based 3-dimentional (3D) planning brachytherapy allows for a better assessment of gross tumor volume (GTV) and the definition and delineation of target volume in cervix cancer. In this study, we investigated the feasibility of our novel computed tomography (CT)-guided free-hand high-dose- rate interstitial brachytherapy (HDRISBT) technique for cervical cancer by evaluating the dosimetry and preliminary clinical outcome of this approach. Dose-volume histogram (DVH) parameters were analyzed according to the Gynecological GEC-ESTRO Working Group recommendations for image-based 3D treatment in cervical cancer. Twenty cervical cancer patients who underwent CT-guided free-hand HDRISBT between March 2009 and June 2010 were studied. With a median of 5 (range, 4-7) implanted needles for each patient, the median dose of brachytherapy alone delivered to 90% of the target volume (D90 ) was 45 (range, 33-54) Gyα/β10 for high-risk clinical target volume (HR-CTV) and 30 (range, 20-36) Gyα/β10 for intermediate-risk clinical target volume (IR-CTV). The percentage of the CTV covered by the prescribed dose (V100 ) of HR-CTV with brachytherapy alone was 81.9%-99.2% (median, 96.7%). With an additional dose of external beam radiotherapy (EBRT), the median D90 was 94 (range, 83-104) Gyα/β10 for HR-CTV and 77 (range, 70 -87) Gyα/β10 for IR-CTV; the median dose delivered to 100% of the target volume (D100 ) was 75 (range, 66-84) Gyα/β10 for HR-CTV and 65 (range, 57-73) Gyα/β10 for IR-CTV. The minimum dose to the most irradiated 2 cc volume (D2cc ) was 73-96 (median, 83) Gyα/β3 for the bladder, 64-98 (median, 73) Gyα/β3 for the rectum, and 52-69 (median, 61) Gyα/β3 for the sigmoid colon. After a median follow-up of 15 months (range, 3 -24 months), two patients experienced local failure, and 1 showed internal iliac nodal metastasis. Despite the relatively small number of needles used, CT-guided HDRISBT for cervical cancer showed favorable DVH parameters and clinical outcome.
文摘OBJECTIVE To evaluate the results and complications associated with nasopharyngeal carcinoma (NPC) treated with combined external-beam radiotherapy (EBR) and intracavitary brachytherapy (IB) using a new-type applicator. METHODS Eighty patients with untreated NPC were divided into two groups based on therapy methods. An experimental group was treated with EBR plus IB and a control group was treated only with EBR. IB was given to the patients of the experimental group when the external radiotherapy dose amounted to more than 60～65 Gy. The total dose of IB was 6～20 Gy and the total dose of EBR of the control group was 70～75 Gy. RESULTS Follow-up was conducted for 97.5% of the patients with results as follows: the overall response rates (ORR) for the experimental and the control groups were 92.5% and 75.3% respectively (P<0.05); the 3 and 5-year survival rates for the experimental group were 87.5% and 74.2% and for the control group, 65.0% and 55.6% (P<0.05); for the experimental group, the 3 and 5-year disease-free survival rates were 72.5% and 64.5% and for the control group, 60.0% and 52.8% (P>0.05).Some complications following radiotherapy showed a signi fi cant difference. CONCLUSION External irradiation plus intracavitary brachytherapy using a new-type applicator may improve the ORR and survival rates, reduce radiation complications and increase the quality of life.
文摘目的:比较局部晚期宫颈癌采用标准三管施源器的腔内后装(tandem and ovoid)与腔内结合组织间插植后装的剂量学差异。方法:CT引导下的三维适形近距离治疗局部晚期宫颈癌患者20例,间隔采用三管式腔内后装与腔内结合组织间插植共72次。按照施源器的不同分成2个组,每组36次,对靶区剂量、危及器官等进行比较。结果:在给予A点相同处方剂量的情况下,HR-CTV D90、D100在三管式腔内后装组与腔内结合组织间插植后装组中分别为(590.0±46.4)cGy、(471.2±66.2)cGy,(502.8±67.7)cGy、(335.9±46.0)cGy,P<0.05),膀胱、直肠、乙状结肠D2cc均相近(P=0.85、0.28、0.53)。结论:采用腔内结合插植后装治疗局部晚期宫颈癌比三管式腔内后装可获得更高的靶区剂量,但长期疗效及晚期反应仍需进一步研究。
