• Int. J. Radiat. Oncol. Biol. Phys. · Jul 2010

    A dose-volume analysis of magnetic resonance imaging-aided high-dose-rate image-based interstitial brachytherapy for uterine cervical cancer.

    • Ken Yoshida, Hideya Yamazaki, Tadashi Takenaka, Tadayuki Kotsuma, Mineo Yoshida, Seiichi Furuya, Eiichi Tanaka, Tadaaki Uegaki, Keiko Kuriyama, Hisanobu Matsumoto, Shigetoshi Yamada, and Chiaki Ban.
    • Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan. kyoshida@onh.go.jp
    • Int. J. Radiat. Oncol. Biol. Phys. 2010 Jul 1; 77 (3): 765-72.

    PurposeTo investigate the feasibility of our novel image-based high-dose-rate interstitial brachytherapy (HDR-ISBT) for uterine cervical cancer, we evaluated the dose-volume histogram (DVH) according to the recommendations of the Gynecological GEC-ESTRO Working Group for image-based intracavitary brachytherapy (ICBT).Methods And MaterialsBetween June 2005 and June 2007, 18 previously untreated cervical cancer patients were enrolled. We implanted magnetic resonance imaging (MRI)-available plastic applicators by our unique ambulatory technique. Total treatment doses were 30-36 Gy (6 Gy per fraction) combined with external beam radiotherapy (EBRT). Treatment plans were created based on planning computed tomography with MRI as a reference. DVHs of the high-risk clinical target volume (HR CTV), intermediate-risk CTV (IR CTV), and the bladder and rectum were calculated. Dose values were biologically normalized to equivalent doses in 2-Gy fractions (EQD(2)).ResultsThe median D90 (HR CTV) and D90 (IR CTV) per fraction were 6.8 Gy (range, 5.5-7.5) and 5.4 Gy (range, 4.2-6.3), respectively. The median V100 (HR CTV) and V100 (IR CTV) were 98.4% (range, 83-100) and 81.8% (range, 64-93.8), respectively. When the dose of EBRT was added, the median D90 and D100 of HR CTV were 80.6 Gy (range, 65.5-96.6) and 62.4 Gy (range, 49-83.2). The D(2cc) of the bladder was 62 Gy (range, 51.4-89) and of the rectum was 65.9 Gy (range, 48.9-76).ConclusionsAlthough the targets were advanced and difficult to treat effectively by ICBT, MRI-aided image-based ISBT showed favorable results for CTV and organs at risk compared with previously reported image-based ICBT results.(c) 2010 Elsevier Inc. All rights reserved.

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