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Brachytherapy. 2014 Jul-Aug;13(4):326-31. doi: 10.1016/j.brachy.2014.03.003.

Impact of dosimetric parameters on local control for patients treated with three-dimensional pulsed dose-rate brachytherapy for cervical cancer.

Author information

1
Department of Radiotherapy, Institut Claudius Regaud, Toulouse, France. Electronic address: boyrie.sabrina@claudiusregaud.fr.
2
Department of Radiotherapy, Centre Alexis-Vautrin, Vandoeuvre-les-Nancy, France.
3
Department of Biostatistics, Centre Alexis-Vautrin, Vandoeuvre-les-Nancy, France.
4
Department of Radiotherapy, Institut Claudius Regaud, Toulouse, France.
5
Department of Radiotherapy, Institut Curie, Paris, France.
6
Department of Radiotherapy, Centre GF Leclerc, Dijon, France.
7
Department of Radiotherapy, Hopital Sud, Amiens, France.
8
Department of Radiotherapy, Hopital de la Pitié Salpétrière, Paris, France.
9
Department of Radiotherapy, Hopital J Minjoz, Besançon, France.
10
Department of Radiotherapy, Centre Léon Bérard, Lyon, France.

Abstract

PURPOSE:

To investigate the impact of dose-volume histograms parameters on local control of three-dimensional (3D) image-based pulsed dose-rate brachytherapy (BT).

METHODS AND MATERIALS:

Within a French multicentric prospective study, the data of the 110 patients treated for cervical cancer with external beam radiotherapy followed by 3D image-based and optimized pulsed dose-rate BT were analyzed. Delineation procedures were performed on magnetic resonance imaging in a minority of cases and on CT for the majority of cases, adapted from the Gynaecological Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology recommendations. Optimization procedure was left to the discretion of the treating center.

RESULTS:

At 2 years, local control rate reached 78%. Dose to Point A, total reference air kerma, and intermediate-risk clinical target volume (IR-CTV) V60 were predictive factors for local control (p = 0.001, p = 0.001, and p = 0.013, respectively). Patients with IR-CTV V60 <75% had a relative risk of local recurrence of 3.8 (95% confidence interval, 1.4-11.1). There was no correlation found between the high-risk clinical target volume dosimetric parameters and local control.

CONCLUSIONS:

This multicentric study has shown that 3D image-based BT provides a high local control rate for cervical cancer patients. The V60 for IR-CTV was identified as an important predictive factor for local control.

KEYWORDS:

Cervical cancer; Local control; Pulsed dose-rate brachytherapy; Three-dimensional brachytherapy

PMID:
24946972
DOI:
10.1016/j.brachy.2014.03.003
[Indexed for MEDLINE]

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