Local Control of Squamous Cell Carcinoma of the Cervix Treated with CT-based Three-dimensional Image-Guided Brachytherapy with or without Central Shielding

Kotaro Yoshio, Hisako Nagasaka, Kento Hisazumi, Hiro Okawa, Nobuhisa Tajiri, Tsuyoki Shiode, Shiro Akaki, Susumu Kanazawa, Tomohiro Mitoma, Yuri Yano, Emiko Kobayashi, Ikuyo Horiguchi, Masayo Takata, Atsushi Hongo, Masaru Yonezawa, Yoshie Nakanishi

    Research output: Contribution to journalArticlepeer-review

    Abstract

    The purposes of this retrospective study were to analyze local control of squamous cell carcinoma of the cervix treated with computed tomography (CT)-based image-guided brachytherapy (IGBT), as well as the factors affecting local control. A total of 39 patients were analyzed. The prescribed dose to the pelvis was 45-50 Gy with or without central shielding (CS). IGBT was delivered in 1-5 fractions. The total dose for high-risk clinical target volume (HR-CTV) was calculated as the biologically equivalent dose in 2-Gy fractions. The median follow-up period was 29.3 months. The 2-year overall survival and local control rates were 97% and 91%, respectively. In univariate analysis, the dose covering 90% of the HR-CTV (D90) and tumor size were found to be significant factors for local control. The cutoff values of tumor size and D90 for local control were 4.3 cm (area under the curve [AUC] 0.75) and 67.7 Gy (AUC 0.84) in the CS group and 5.3 cm (AUC 0.75) and 73.7 Gy (AUC 0.78) in the group without CS, respectively. However, though the local control of CT-based IGBT was favorable, the results suggested that the dose required for tumor control may differ depending on the presence of CS.

    Original languageEnglish
    Pages (from-to)79-85
    Number of pages7
    JournalActa medica Okayama
    Volume75
    Issue number1
    Publication statusPublished - 2021

    Keywords

    • brachytherapy
    • central shielding
    • cervical cancer
    • squamous cell cancer

    ASJC Scopus subject areas

    • Biochemistry, Genetics and Molecular Biology(all)

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