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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Cervical tumor control evaluated with ICRU 38 reference volumes and integrated reference air kerma.
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Cervical tumor control evaluated with ICRU 38 reference volumes and integrated reference air kerma.

机译：用ICRU 38参考体积和综合参考空气比释动能评估宫颈肿瘤控制。

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PURPOSE: The purpose of this investigation was to evaluate the relationship of ICRU 38 reference volumes and integrated reference air kerma to primary cervical tumor control. MATERIALS AND METHODS: This retrospective study includes 1253 women with carcinoma of the uterine cervix treated with radiotherapy. Patients were treated from 1959 to 1993 at the Mallinckrodt Institute of Radiology. There were 39 women with stage Ia disease, 211 with stage Ib1, 88 with stage Ib2, 580 with stage 2, and 335 with stage 3 disease. Most patients with stage Ia disease were treated with low dose rate brachytherapy alone. All other patients were treated with external irradiation and low dose rate brachytherapy. External irradiation doses ranged from 8.2-63.8 Gy to the whole pelvis and an additional parametrial boost to deliver a total of 65-75 Gy to Point P depending on tumor stage. Low dose rate brachytherapy was delivered to the primary tumor with doses ranging from 40x10(4)-60x10(4) Gy cm(2) (integrated reference air kerma; IRAK). Isodose reference volumes (60-160 Gy) and point A doses were determined for all patients. Tumor control was defined as control of the primary cervical cancer with or without failure at other pelvic or distant sites. RESULTS: The mean 60 Gy volume was calculated to be 139.5 cm(3) for stage Ia, 200.4 cm(3) for stage Ib1, 270.9 cm(3) for stage Ib2, 235 cm(3) for stage 2, and 293.4 cm(3) for stage 3. No patient with stage Ia disease had a failure in the cervix. For stage Ib1 tumors the mean 60 Gy volume was 219.1 cm(3) for those who failed in the cervix and 199.9 cm(3) for those who did not fail (P=0.73). For stage Ib2 tumors the mean 60 Gy volume was 354.4 cm(3) for those who failed and 260.2 cm(3) for those who did not fail (P=0.004). The mean 60 Gy volume was 249.3 cm(3) for those with stage 2 disease who failed and 233.8 cm(3) for those who did not fail (P=0.02). For patients with stage 3 cancer the mean 60 Gy volume was 321.6 cm(3) for those who failed and 287.3 cm(3) for those who did not fail(P=0.20). Reference volumes from 70-160 Gy were not statistically different within each stage for those who failed in the cervix compared to those who did not fail. Cervical recurrences by clinical stage did not have statistically significant differences for mean IRAK except for stage II disease (P=0.001). CONCLUSION: Analysis of the 60-160 Gy reference volumes and IRAK failed to demonstrate a consistent positive increasing correlation of these values to primary cervical tumor control.
机译：目的：本研究的目的是评估ICRU 38参考量和综合参考空气比释动能与原发性宫颈肿瘤控制的关系。材料与方法：这项回顾性研究纳入了1253例接受放射治疗的宫颈癌妇女。从1959年至1993年在Mallinckrodt放射研究所对患者进行了治疗。 Ia期疾病的女性有39名，Ib1期的女性为211名，Ib2期的女性为88名，2期的女性为580名，三级疾病的女性为335名。大多数患有Ia期疾病的患者仅接受低剂量率近距离放射治疗。所有其他患者均接受外部照射和低剂量率近距离放射治疗。整个骨盆的外部照射剂量范围为8.2-63.8 Gy，并根据子宫癌的分期，额外进行子宫旁刺激以向P点递送总计65-75 Gy。低剂量率近距离放射治疗以40x10（4）-60x10（4）Gy cm（2）的剂量传递至原发性肿瘤（综合参考空气比释动能; IRAK）。确定所有患者的等剂量参考体积（60-160 Gy）和A点剂量。肿瘤控制被定义为原发性子宫颈癌的控制，在其他骨盆或远处失败。结果：Ia期的平均60 Gy体积计算为139.5 cm（3），Ib1期的平均体积为200.4 cm（3），Ib2期的为270.9 cm（3），2期为235 cm（3），293.4 cm （3）对于阶段3。没有患有Ia期疾病的患者子宫颈衰竭。对于Ib1期肿瘤，宫颈失败者的平均60 Gy体积为219.1 cm（3），而未失败者的平均60 Gy体积为199.9 cm（3）（P = 0.73）。对于Ib2期肿瘤，失败者的平均60 Gy体积为354.4 cm（3），未失败者的平均60 Gy体积为260.2 cm（3）（P = 0.004）。对于患有失败的2期疾病的患者，平均60 Gy体积为249.3 cm（3），对于没有衰竭的患者，平均60 Gy体积为233.8 cm（3）（P = 0.02）。对于患有3期癌症的患者，失败者的平均60 Gy体积为321.6 cm（3），而未失败者的平均60 Gy体积为287.3 cm（3）（P = 0.20）。与未失败者相比，子宫颈失败者在每个阶段的70-160 Gy参考量在统计学上没有差异。除II期疾病外，按临床阶段划分的宫颈复发与平均IRAK无统计学差异（P = 0.001）。结论：对60-160 Gy参考量和IRAK的分析未能证明这些值与原发性宫颈肿瘤控制呈持续正相关。

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