Clinical outcomes in cervical cancer patients treated by FDG-PET/CT-based 3-dimensional planning for the first brachytherapy session.

Oh, Dongryul; Huh, Seung Jae; Park, Won; Ju, Sang Gyu; Nam, Heerim; Lee, Jeong Eun
Medicine
2016Jun ; 95 ( 25 ) :e3895.
저자 상세정보
Oh, Dongryul -
Huh, Seung Jae -
Park, Won -
Ju, Sang Gyu -
Nam, Heerim -
Lee, Jeong Eun -
ABSTRACT
The aim of the study was to evaluate the treatment outcomes in cervical cancer patients treated with 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT)-guided 3-dimensional brachytherapy (3D-BT) planning for the first brachytherapy session.We retrospectively analyzed 87 patients with cervical cancer who received definitive radiotherapy (RT). Primary tumor size was ???cm in 22 patients (25.3%), >4?cm and ???cm in 45 patients (51.7%), and >6?cm in 20 patients (23.0%). The median total dose of external beam RT was 50.4 (50.4-60.4) Gy. FDG-PET/CT-guided 3D-BT with an iridium-192 source was performed. The clinical target volume (CTV) for 3D-BT included the entire cervix and the abnormal FDG-uptake with a 1-cm expansion. A planned total dose was 24 Gy at 4 Gy per insertion 3 times per week using a tandem and 2 ovoids.The mean D95 and D90 for the CTV were 73.4 (짹5.9) Gy and 77.9 (짹6.9) Gy, respectively (EQD2, 慣/棺=10). The D2cc for the rectum and bladder was 374 (짹97.4) cGy and 394 (짹107.6) cGy per fraction, respectively. The EQD2?(慣/棺=3) for the D2cc was 74.5 (짹12.4) Gy for the rectum and 77.3 (짹14.6) Gy for the bladder. The median follow-up period was 40 (8-61) months. The 3-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 84.7%, 72.1%, and 89.2%, respectively. The 3-year LC rate was 100% for tumors ??4?cm, 91.1% for tumors > 4?cm and ??6?cm, and 70.5% for tumors > 6?cm (P?=?0.014). Local failure developed in 9 patients. Three patients had local failures outside of the CTV. Grade 1, 2, and 3 rectal bleeding developed in 5, 4, and 2 patients, respectively. One patient experienced rectovaginal fistula.FDG-PET/CT-guided 3D-BT planning is a feasible approach, which showed favorable clinical outcomes.
brachytherapy, cervical cancer, FDG-PET, radiotherapy
MESH
Adult, Aged, Aged, 80 and over, Brachytherapy/*methods, Disease-Free Survival, Female, Humans, *Imaging, Three-Dimensional, Middle Aged, Neoplasm Staging/*methods, Positron Emission Tomography Computed Tomography/*methods, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted/methods, Republic of Korea/epidemiology, Retrospective Studies, Survival Rate/trends, Treatment Outcome, Uterine Cervical Neoplasms/diagnosis/mortality/*radiotherapy
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
FDG-PET/CT-based 3D-BT showed favorable clinical outcomes, which is equivalent to those of other image-guided brachytherapy.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
10.1097/MD.0000000000003895
KCD코드
ICD 03
건강보험코드