Email updates

Keep up to date with the latest news and content from BMC Cancer and BioMed Central.

Open Access Research article

CT based three dimensional dose-volume evaluations for high-dose rate intracavitary brachytherapy for cervical cancer

Naoya Murakami1*, Takahiro Kasamatsu2, Akihisa Wakita1, Satoshi Nakamura1, Hiroyoki Okamoto1, Koji Inaba1, Madoka Morota1, Yoshinori Ito1, Minako Sumi1 and Jun Itami1

Author Affiliations

1 Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji Chuo-ku, Tokyo 104-0045, Japan

2 Department of Gynecologic Oncology, National Cancer Center Hospital, 5-1-1, Tsukiji Chuo-ku, Tokyo 104-0045, Japan

For all author emails, please log on.

BMC Cancer 2014, 14:447  doi:10.1186/1471-2407-14-447

Published: 17 June 2014

Abstract

Background

In this study, high risk clinical target volumes (HR-CTVs) according to GEC-ESTRO guideline were contoured retrospectively based on CT images taken at the time of high-dose rate intracavitary brachytherapy (HDR-ICBT) and correlation between clinical outcome and dose of HR-CTV were analyzed.

Methods

Our study population consists of 51 patients with cervical cancer (Stages IB-IVA) treated with 50 Gy external beam radiotherapy (EBRT) using central shield combined with 2–5 times of 6 Gy HDR-ICBT with or without weekly cisplatin. Dose calculation was based on Manchester system and prescribed dose of 6 Gy were delivered for point A. CT images taken at the time of each HDR-ICBT were reviewed and HR-CTVs were contoured. Doses were converted to the equivalent dose in 2 Gy (EQD2) by applying the linear quadratic model (α/β = 10 Gy).

Results

Three-year overall survival, Progression-free survival, and local control rate was 82.4%, 85.3% and 91.7%, respectively. Median cumulative dose of HR-CTV D90 was 65.0 Gy (52.7-101.7 Gy). Median length from tandem to the most lateral edge of HR-CTV at the first ICBT was 29.2 mm (range, 18.0-51.9 mm). On univariate analysis, both LCR and PFS was significantly favorable in those patients D90 for HR-CTV was 60 Gy or greater (p = 0.001 and 0.03, respectively). PFS was significantly favorable in those patients maximum length from tandem to edge of HR-CTV at first ICBT was shorter than 3.5 cm (p = 0.042).

Conclusion

Volume-dose showed a relationship to the clinical outcome in CT based brachytherapy for cervical carcinoma.

Keywords:
Brachytherapy; Image-based gynecological brachytherapy; Cervical cancer; IGBT; CT-based gynecological brachytherapy