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首页> 外文期刊>Brachytherapy >Interstitial preoperative high-dose-rate brachytherapy for early stage cervical cancer: Dose-volume histogram parameters, pathologic response and early clinical outcome
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Interstitial preoperative high-dose-rate brachytherapy for early stage cervical cancer: Dose-volume histogram parameters, pathologic response and early clinical outcome

机译：早期宫颈癌的间质性术前大剂量近距离放射治疗：剂量-体积直方图参数，病理反应和早期临床结果

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Purpose: To analyze dose-volume histogram parameters and pathologic response after preoperative high-dose-rate brachytherapy (HDRB) for high-risk early stage cervical cancers (ESCCs). Methods and Materials: From June 2007 to December 2011, 32 patients with a histologically proven invasive cervical cancer with high risk of local recurrence (size 2. cm, adenocarcinoma type, perineural and/or lymphovascular invasion) underwent a preoperative HDRB, which delivered a total dose of 39. Gy in nine fractions over 5 days. All the patients underwent hysterectomy after HDRB. Results: With a median clinical target volume of 50cc (minimum-maximum, 42-74), the median V100 was 49cc (minimum-maximum, 42-50). Median D90 was 45Gy (equivalent dose at 2Gy per fraction, 56Gyαβ10). Median D2cc was 34Gy, 31Gy, 28Gy, and 38Gyαβ3 for bladder, rectum, sigmoid, and vagina, respectively. Twenty-eight patients (88.5%) achieved a complete histologic response after surgery, whereas for the 4 remaining patients, residual tumor cells (3 patients) and gross residual disease (1 patient) were observed in the pathologic specimen. With a median followup of 24 months (minimum-maximum, 5-48), no local recurrence was observed; 1 patient died of intercurrent cause. Early toxicity occurred within the 30 days after HDRB (Common Terminology Criteria for Adverse Events v3.0) was G1 diarrhea for 15 patients (47%) and G1 urinary frequency or urgency for 13 patients (40.6%). No G2-G3 toxicities were noticed. Conclusions: Preoperative HDRB for high-risk ESCCs represents a well-tolerated procedure, which leads to a high rate of postoperative pathologic response. Dose-volume histogram parameters were at least equivalent to those obtained with a low-dose-rate procedure. Long-term results will help to analyze the place of preoperative brachytherapy in the management of high-risk ESCCs.
机译：目的：分析术前高剂量率近距离放射治疗（HDRB）治疗高危早期宫颈癌（ESCC）的剂量-体积直方图参数和病理反应。方法和材料：2007年6月至2011年12月，对32例经组织学证实为浸润性宫颈癌且局部复发风险高（> 2。cm，腺癌类型，神经周和/或淋巴管浸润）的患者进行术前HDRB，分娩总剂量为39. Gy，分5天内服用9次。 HDRB术后所有患者均行子宫切除术。结果：在中位数临床目标量为50cc（最小-最大，42-74）时，中位数V100为49cc（最小-最大，42-50）。 D90的中位数为45Gy（相当于每份2Gy的剂量，即56Gyαβ10）。膀胱，直肠，乙状结肠和阴道的D2cc中位数分别为34Gy，31Gy，28Gy和38Gyαβ3。 28名患者（88.5％）在手术后获得了完整的组织学反应，而在其余4名患者中，在病理标本中观察到了残留的肿瘤细胞（3例）和总体残留的疾病（1例）。中位随访24个月（最小-最大，5-48），未观察到局部复发。 1例患者死于并发原因。在HDRB（不良事件通用术语标准v3.0）之后，在30天内发生了早期毒性反应，其中15例患者（47％）发生了G1腹泻，13例患者（40.6％）出现了G1尿频或尿急。没有发现G2-G3毒性。结论：高危ESCC的术前HDRB耐受性良好，导致术后病理反应率高。剂量-体积直方图参数至少等于使用低剂量率程序获得的参数。长期结果将有助于分析术前近距离放射治疗在高危ESCC管理中的地位。

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