Computed Tomography-Based High-Dose-Rate Intracavitary Brachytherapy for Uterine Cervical Cancer: Preliminary Demonstration of Correlation Between Dose-Volume Parameters and Rectal Mucosal Changes Observed by Flexible Sigmoidoscopy

Journal Article · Wed Aug 01 00:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.02.009· OSTI ID:20953603

Koom, Woong Sub ^[1]; Sohn, Dae Kyung ^[1]; Kim, Joo-Young ^[1]; Kim, Jong Won ^[1]; Shin, Kyung Hwan ^[1]; Yoon, Sang Min ^[1]; Kim, Dae Yong ^[1]; Yoon, Myonggeun ^[1]; Shin, Dongho ^[1]; Park, Sung Yong ^[1]; Cho, Kwan Ho ^[1]

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1. Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi (Korea, Republic of)

Purpose: To compare the dose-volume histogram (DVH) parameters obtained by three-dimensional gynecologic brachytherapy planning with the rectosigmoid mucosal changes observed by flexible sigmoidoscopy. Methods and Materials: Between January 2004 and July 2005, 71 patients with International Federation of Gynecology and Obstetrics Stage IB-IIIB uterine cervical cancer underwent computed tomography-based high-dose-rate intracavitary brachytherapy. The total dose (external beam radiotherapy [RT] plus intracavitary brachytherapy) to the International Commission of Radiation Units and Measurements rectal point (ICRU{sub RP}) and DVH parameters for rectosigmoid colon were calculated using the equivalent dose in 2-Gy fractions ({alpha}/{beta} = 3 Gy). Sigmoidoscopy was performed every 6 months after RT, with the 6-scale scoring system used to determine mucosal changes. Results: The mean values of the DVH parameters and ICRU{sub RP} were significantly greater in patients with a score of {>=}2 than in those with a score <2 at 12 months after RT (ICRU{sub RP}, 71 Gy{sub {alpha}}{sub /{beta}}{sub 3} vs. 66 Gy{sub {alpha}}{sub /{beta}}{sub 3}, p = 0.02; D{sub 0.1cc}, 93 Gy{sub {alpha}}{sub /{beta}}{sub 3} vs. 85 Gy{sub {alpha}}{sub /{beta}}{sub 3}, p = 0.04; D{sub 1cc}, 80 Gy{sub {alpha}}{sub /{beta}}{sub 3} vs. 73 Gy{sub {alpha}}{sub /{beta}}{sub 3}, p = 0.02; D{sub 2cc}, 75 Gy{sub {alpha}}{sub /{beta}}{sub 3} vs. 69 Gy{sub {alpha}}{sub /{beta}}{sub 3}, p = 0.02). The probability of a score of {>=}2 showed a significant relationship with the DVH parameters and ICRU{sub RP} (ICRU{sub RP}, p = 0.03; D{sub 0.1cc}, p = 0.05; D{sub 1cc}, p = 0.02; D{sub 2cc}, p = 0.02). Conclusion: Our preliminary data have shown that DVH values of the rectosigmoid colon obtained by computed tomography-based three-dimensional brachytherapy planning are reliable and predictive of score {>=}2 rectosigmoid mucosal changes.

• OSTI ID: 20953603
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRACHYTHERAPY
CARCINOMAS
COMPUTERIZED TOMOGRAPHY
DOSE EQUIVALENTS
DOSE RATES
GYNECOLOGY
ICRU
PATIENTS
PLANNING
RADIATION DOSES
RECTUM