Literature DB >> 16078262

Dosimetric parameters that predict late rectal complications after curative radiotherapy in patients with uterine cervical carcinoma.

Tae Hyun Kim1, Jinho Choi, Sung-Yong Park, Seok-Ho Lee, Kyu-Chan Lee, Dae Sik Yang, Kyung Hwan Shin, Kwan Ho Cho, Hyun-Sun Lim, Joo-Young Kim.   

Abstract

BACKGROUND: Late rectal complication (LRC) was a major late complication in patients with uterine cervical carcinoma who were treated with a combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary irradiation (HDR-ICR). For the current study, the authors retrospectively evaluated dosimetric parameters that were correlated with LRC > or = Grade 2 in patients with uterine cervical carcinoma who were treated with curative radiotherapy, and they analyzed the appropriate dose estimates to the rectum that were predictive for LRC > or = Grade 2.
METHODS: Between July 1994 and September 2002, 157 patients who were diagnosed with Stage IB-IIIB cervical carcinoma and were treated with definitive radiotherapy were included. EBRT (41.4-66 grays [Gy] in 23-33 fractions) to the whole pelvis was delivered to all patients, with midline shielding performed after a 36-50.4 Gy external dose. HDR-ICR (21-39 Gy in 6-13 fractions to Point A) was administered at a rate of 2 fractions weekly after midline shielding of EBRT. LRC was scored using Radiation Therapy Oncology Group criteria. The total biologically effective dose (BED) at specific points, such as Point A (BED(Point A)), rectal point (BED(RP)), and maximal rectal point (BED(MP)), was determined by a summation of the EBRT and HDR-ICR components, in which the alpha/beta ratio was set to 3. Analyzed parameters included patient age, tumor size, stage, concurrent chemotherapy, ICR fraction size, RP ratio (dose at the rectal point according to the Point A dose), MP ratio (dose at the maximal rectal point according to the Point A dose), EBRT dose, BED(Point A), BED(RP), and BED(MP).
RESULTS: The 5-year actuarial overall rate of LRC > or = Grade 2 in all patients was 18.4%. Univariate analysis showed that the RP ratio, MP ratio, EBRT dose, BED(Point A), BED(RP), and BED(MP) were correlated with LRC > or = Grade 2 (P < 0.05). Multivariate analysis showed that, of all clinical and dosimetric parameters evaluated, only BED(RP) was correlated with LRC > or = Grade 2 (P = 0.009). The 5-year actuarial rate of LRC > or = Grade 2 was 5.4% in patients with a BED(RP) < 125 Gy(3) and 36.1% in patients with a BED(RP) > or = 125 Gy(3) (P < 0.001).
CONCLUSIONS: BED(RP) was a useful dosimetric parameter for predicting the risk of LRC > or = Grade 2 and should be limited to < 125 Gy(3) whenever possible to minimize the risk of LRC > or = Grade 2 in patients with uterine cervical carcinoma who are treated with a combination of EBRT and HDR-ICR. Cancer 2005. Copyright 2005 American Cancer Society.

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Mesh:

Year:  2005        PMID: 16078262     DOI: 10.1002/cncr.21292

Source DB:  PubMed          Journal:  Cancer        ISSN: 0008-543X            Impact factor:   6.860


  7 in total

Review 1.  External beam techniques to boost cervical cancer when brachytherapy is not an option-theories and applications.

Authors:  Omar Mahmoud; Sarah Kilic; Atif J Khan; Sushil Beriwal; William Small
Journal:  Ann Transl Med       Date:  2017-05

2.  Biological effective dose evaluation in gynaecological brachytherapy: LDR and HDR treatments, dependence on radiobiological parameters, and treatment optimisation.

Authors:  C Bianchi; F Botta; L Conte; P Vanoli; L Cerizza
Journal:  Radiol Med       Date:  2008-07-10       Impact factor: 3.469

3.  The association of rectal equivalent dose in 2 Gy fractions (EQD2) to late rectal toxicity in locally advanced cervical cancer patients who were evaluated by rectosigmoidoscopy in Faculty of Medicine, Chiang Mai University.

Authors:  Ekkasit Tharavichtikul; Pooriwat Meungwong; Taned Chitapanarux; Somvilai Chakrabandhu; Pitchayaponne Klunklin; Wimrak Onchan; Somsak Wanwilairat; Patrinee Traisathit; Razvan Galalae; Imjai Chitapanarux
Journal:  Radiat Oncol J       Date:  2014-06-30

4.  Endoscopic findings of rectal mucosal damage after pelvic radiotherapy for cervical carcinoma: correlation of rectal mucosal damage with radiation dose and clinical symptoms.

Authors:  Tae Gyu Kim; Seung Jae Huh; Won Park
Journal:  Radiat Oncol J       Date:  2013-06-30

5.  A prospective observational study with dose volume parameters predicting rectosigmoidoscopic findings and late rectosigmoid bleeding in patients with uterine cervical cancer treated by definitive radiotherapy.

Authors:  Tae Hyun Kim; Joo-Young Kim; Dae Kyung Sohn; Yeon-Joo Kim; Yoon-Seok Lee; Sung Ho Moon; Sang Soo Kim; Dae Yong Kim
Journal:  Radiat Oncol       Date:  2013-01-31       Impact factor: 3.481

6.  The usefulness of fleet rectal enemas on high-dose-rate intracavitary cervical cancer brachytherapy. A prospective trial.

Authors:  Ignacio Andres; Manuel Gutierrez-Perez; Maria Pilar Rodriguez-Vela; Roberto Berenguer; Marimar Sevillano; Manuel Aguayo; Meritxell Arenas; Angeles Rovirosa; Yashmina Murria-Perez; Sebastia Sabater
Journal:  J Contemp Brachytherapy       Date:  2017-05-30

7.  The Relationship Between Late Morbidity and Dose-Volume Parameter of Rectum in Combined Intracavitary/Interstitial Cervix Cancer Brachytherapy: A Mono-Institutional Experience.

Authors:  Ning Zhang; Ying Liu; Dongmei Han; Xin Guo; Zhuang Mao; Wei Yang; Guanghui Cheng
Journal:  Front Oncol       Date:  2021-07-23       Impact factor: 6.244

  7 in total

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