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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >DVH parameters and outcome for patients with early-stage cervical cancer treated with preoperative MRI-based low dose rate brachytherapy followed by surgery.
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DVH parameters and outcome for patients with early-stage cervical cancer treated with preoperative MRI-based low dose rate brachytherapy followed by surgery.

机译：术前以MRI为基础的低剂量率近距离放射治疗并随后进行手术治疗的早期宫颈癌患者的DVH参数和结果。

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BACKGROUND: To our knowledge no DVH data have so far been reported for MRI-guided BT in the preoperative setting of early-stage cervical cancer. We assessed DVH parameters and clinical outcome using 3D MRI-guided preoperative intracavitary LDR BT. PATIENTS AND METHODS: Thirty-nine patients with primary early cervical carcinoma (IB1 37, IIA 1 and IIB 1) were treated with preoperative MRI-based LDR BT, consisting of uterovaginal BT to a total dose of 60 Gy to the intermediate-risk CTV, followed 6 weeks later by bilateral salpingo-oophorectomy and extrafascial hysterectomy plus pelvic node dissection. Adjuvant chemoradiation was delivered to patients with pelvic lymph node involvement. RESULTS: With a median follow-up of 4.4 years (range 2.6-6.6 years), local recurrence occurred in 1 patient (a lateropelvic relapse) (2.6%). The 4-year actuarial overall survival and disease-free survival were 94% (95% CI, 82-98), and 86% (95% CI, 67-95), respectively. The 2- and 4-year actuarial local relapse-free survival were 94 (95% CI, 86-100) and 91% (95% CI, 81-100), respectively. For intermediate-risk CTV, median D(100) and D(90) were 43 Gy(alpha)(/)(beta)(10) (range 2-74 Gy(alpha)(/)(beta)(10)) and 75 Gy(alpha/beta)(10), respectively (range 29-129 Gy(alpha/beta)(10)). For high-risk CTV, the median D(100) and D(90) were 69 Gy(alpha/beta)(10) (range 24-137 Gy(alpha/beta)(10)) and 109 Gy(alpha/beta)(10) (range 37-198 Gy(alpha/beta)(10)), respectively. Twenty grade 1-2 late complications were observed in 13 patients (33.3%): 10 bladder, 3 ureteral, 1 rectal, 1 small bowel, 1 vaginal, 1 pelvic fibrosis, 1 peripheral nerve, and 2 others. No grade 3 or 4 complication occurred. CONCLUSION: MRI-guided brachytherapy with adaptation of the time duration and/or the length of each radioactive source allows both high local control and low toxicity in the preoperative settings of early-stage cervical cancers.
机译：背景：据我们所知，迄今为止，尚无关于早期宫颈癌术前MRI引导BT的DVH数据的报道。我们使用3D MRI指导的术前腔内LDR BT评估了DVH参数和临床结局。患者和方法：对39例原发性早期子宫颈癌（IB1 37，IIA 1和IIB 1）患者进行了术前基于MRI的LDR BT治疗，其中子宫阴道BT剂量为中危CTV的总剂量为60 Gy ，然后在6周后进行双侧输卵管卵巢切除术和筋膜外子宫切除术以及盆腔淋巴结清扫术。伴有盆腔淋巴结转移的患者接受了辅助化学放疗。结果：中位随访时间为4.4年（范围为2.6-6.6年），其中1例患者发生局部复发（盆腔后复发）（2.6％）。 4年的精算总生存率和无病生存率分别为94％（95％CI，82-98）和86％（95％CI，67-95）。 2年和4年的精算局部无复发生存率分别为94（95％CI，86-100）和91％（95％CI，81-100）。对于中等风险的CTV，中位数D（100）和D（90）为43Gyα（/）β（10）（范围2-74Gyα（/）β（10））分别为75和75Gyα/β（10）（范围为29-129Gyα/β（10））。对于高风险的CTV，中位数D（100）和D（90）为69Gyα/β（10）（范围24-137Gyα/β（10））和109Gyα/β ）（10）（范围为37-198 Gy（alpha / beta）（10））。在13例患者中观察到20 1-2级晚期并发症（33.3％）：膀胱10例，输尿管3例，直肠1例，小肠1例，阴道1例，盆腔纤维化1例，周围神经1例，另外2例。没有发生3级或4级并发症。结论：在早期宫颈癌的术前设置中，采用MRI引导的近距离放射疗法，并根据每个放射源的持续时间和/或长度进行调整，可以实现较高的局部控制和低毒性。

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