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首页> 外文期刊>Journal of Cancer Research and Therapeutics >Comparison of volume doses from conventional two-dimensional brachytherapy with corresponding doses from three-dimensional magnetic resonance imaging-based brachytherapy in carcinoma cervix
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Comparison of volume doses from conventional two-dimensional brachytherapy with corresponding doses from three-dimensional magnetic resonance imaging-based brachytherapy in carcinoma cervix

机译：常规二维近距离放射疗法的体积剂量与基于三维磁共振成像的近距离放射疗法在宫颈癌中的相应剂量的比较

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Purpose: The purpose of this study was to evaluate the doses delivered to the brachytherapy (BT) target volume and organs at risk from two-dimensional X-ray-based plans on magnetic resonance imaging (MRI) and to compare these doses with the corresponding doses from the image-based optimized plans. Materials and Methods: Twenty patients with cervical cancer treated with chemoradiation and BT were included in this study. All patients had two sets of treatment plans generated for the first fraction of BT. Volume doses resulting from MRI-based optimized plans were compared with the corresponding doses from standard “Point A” prescription plans. Results: There was statistically significant difference between the two planning modalities for the mean high-risk clinical target volume (HRCTV) D90 doses (P = 0.0014) although mean D2cc of bladder (P = 0.1667) and rectum (P = 0.051) was not different. Standard plans with a prescription dose of 7 Gy to Point A delivered a mean HRCTV D90 of 10.07 Gy in patients with no gross residual disease at the time of BT, which was very similar to the mean dose from MR-based plans (MRI 10.02 Gy and standard 10.07 Gy). The only factor seen affecting dose distribution in this group was the applicator geometry. Standard plans failed to deliver HRCTV D90 doses of 8.5 Gy in all patients with gross residual disease. The doses were Conclusion: Conventional X-ray-based plans with moderate Point A doses deliver HRCTV D90 comparable to MRI-based plans in patients with no residual disease, and centrally placed residual disease, provided proper applicator placement and ideal geometry can be ensured. Soft-tissue image-based BT dose optimization ought to be considered in all patients with gross residual disease at the time of brachytherapy.
机译：目的：本研究的目的是评估基于二维X射线磁共振成像（MRI）计划的近距离放射治疗（BT）目标体积和有风险器官的剂量，并将这些剂量与相应剂量进行比较来自基于图像的优化计划的剂量。材料与方法：本研究纳入了20例接受化学放射和BT治疗的宫颈癌患者。所有患者都有针对第一部分BT产生的两组治疗计划。将基于MRI的优化计划产生的体积剂量与标准“ Point A”处方计划中的相应剂量进行比较。结果：尽管没有平均膀胱D2cc（P = 0.1667）和直肠（P = 0.051）的平均高风险临床目标体积（HRCTV）D90剂量（P = 0.0014），两种规划方式之间在统计学上有显着差异。不同。在BT时无严重残留疾病的患者中，对A点开具7 Gy处方剂量的标准计划的平均HRCTV D90为10.07 Gy，这与基于MR的计划的平均剂量非常相似（MRI 10.02 Gy和标准的10.07 Gy）。观察到影响剂量分布的唯一因素是施药器的几何形状。标准计划未能在所有有严重残留疾病的患者中提供大于8.5 Gy的HRCTV D90剂量。剂量得出的结论是：在无残留病灶且位于中央残留病灶的患者中，常规的基于X射线的中等A点剂量方案可提供与基于MRI方案相当的HRCTV D90，前提是可以确保正确放置施药器和理想的几何形状。在进行近距离放射治疗时，所有患有严重残留疾病的患者均应考虑基于软组织图像的BT剂量优化。

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