Dose-Volume Histogram Parameters and Late Side Effects in Magnetic Resonance Image-Guided Adaptive Cervical Cancer Brachytherapy

Journal Article · Mon Jan 31 23:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.11.002· OSTI ID:21491571

Georg, Petra ^[1]; Lang, Stefan; Dimopoulos, Johannes C.A. ^[1]; Doerr, Wolfgang ^[1]; Sturdza, Alina E; Berger, Daniel; Georg, Dietmar; Kirisits, Christian; Poetter, Richard ^[1]

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1. Department of Radiotherapy, Medical University of Vienna, Vienna (Austria)

Purpose: To evaluate the predictive value of dose-volume histogram (DVH) parameters for late side effects of the rectum, sigmoid colon, and bladder in image-guided brachytherapy for cervix cancer patients. Methods and Materials: A total of 141 patients received external-beam radiotherapy and image-guided brachytherapy with or without chemotherapy. The DVH parameters for the most exposed 2, 1, and 0.1 cm{sup 3} (D{sub 2cc}, D{sub 1cc}, and D{sub 0.1cc}) of the rectum, sigmoid, and bladder, as well as International Commission on Radiation Units and Measurements point doses (D{sub ICRU}) were computed. Total doses were converted to equivalent doses in 2 Gy by applying the linear-quadratic model ({alpha}/{beta} = 3 Gy). Late side effects were prospectively assessed using the Late Effects in Normal Tissues-Subjective, Objective, Management and Analytic score. The following patient groups were defined: Group 1: no side effects (Grade 0); Group 2: side effects (Grade 1-4); Group 3: minor side effects (Grade 0-1); and Group 4: major side effects (Grade 2-4). Results: The median follow-up was 51 months. The overall 5-year actuarial side effect rates were 12% for rectum, 3% for sigmoid, and 23% for bladder. The mean total D{sub 2cc} were 65 {+-} 12 Gy for rectum, 62 {+-} 12 Gy for sigmoid, and 95 {+-} 22 Gy for bladder. For rectum, statistically significant differences were observed between Groups 1 and 2 in all DVH parameters and D{sub ICRU}. Between Groups 3 and 4, no difference was observed for D{sub 0.1cc.} For sigmoid, significant differences were observed for D{sub 2cc} and D{sub 1cc}, but not for D{sub 0.1cc} in all groups. For bladder, significant differences were observed for all DVH parameters only comparing Groups 3 and 4. No differences were observed for D{sub ICRU}. Conclusions: The parameters D{sub 2cc} and D{sub 1cc} have a good predictive value for rectal toxicity. For sigmoid, no prediction could be postulated because of limited data. In bladder, DVH parameters were predictive only for major toxicity.

• OSTI ID: 21491571
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 2 Vol. 79; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BLADDER
BODY
BRACHYTHERAPY
DIAGNOSTIC TECHNIQUES
DIGESTIVE SYSTEM
DISEASES
DOSES
GASTROINTESTINAL TRACT
INTESTINES
LARGE INTESTINE
MEDICINE
NEOPLASMS
NMR IMAGING
NUCLEAR MEDICINE
ORGANS
RADIATION DOSES
RADIOLOGY
RADIOTHERAPY
RECTUM
SIDE EFFECTS
THERAPY
TOXICITY
URINARY TRACT
UROGENITAL SYSTEM DISEASES