PURPOSE: We investigated whether conventional tandem-source dwelling to cover the entire uterus, classically regarded as the target volume, is necessary in modern intracavitary radiotherapy (ICRT) for cervical cancer. MATERIALS AND METHODS: The study included 95 cervical squamous cell carcinoma patients treated by high-dose-rate ICRT (point A dose was 6.0 Gy, with three to five insertions per patient) after external beam radiotherapy (EBRT), with central pelvic doses of 12-50 Gy. The tandem-source dwell length was adjusted to the target volume specified by magnetic resonance (MR) imaging. A tandem applicator was inserted as far as the uterine fundus in accordance with the post-EBRT MR-assessed cavity length. The pre-EBRT MR-specified target volume was used for the dwell-length adjustment. The safety of the dwell-length adjustment was assessed in terms of treatment failure. RESULTS: The dwell-length adjustment was made in 248 of 366 total insertions with a dwell-length reduction of 5-55 mm (median 15 mm) at the corpus. Pelvic failure was identified in 22 patients with a 2-year pelvic disease-free survival rate of 75.6% but without evidence of failure at dwelling-skipped corpuses. CONCLUSION: Given after pelvic EBRT and ICRT of full-length dwelling in part, which may have eradicated possible subclinical extension, adjustment of the tandem-source dwell length to the MR-specified target volume appeared to be safe.
PURPOSE: We investigated whether conventional tandem-source dwelling to cover the entire uterus, classically regarded as the target volume, is necessary in modern intracavitary radiotherapy (ICRT) for cervical cancer. MATERIALS AND METHODS: The study included 95 cervical squamous cell carcinomapatients treated by high-dose-rate ICRT (point A dose was 6.0 Gy, with three to five insertions per patient) after external beam radiotherapy (EBRT), with central pelvic doses of 12-50 Gy. The tandem-source dwell length was adjusted to the target volume specified by magnetic resonance (MR) imaging. A tandem applicator was inserted as far as the uterine fundus in accordance with the post-EBRT MR-assessed cavity length. The pre-EBRT MR-specified target volume was used for the dwell-length adjustment. The safety of the dwell-length adjustment was assessed in terms of treatment failure. RESULTS: The dwell-length adjustment was made in 248 of 366 total insertions with a dwell-length reduction of 5-55 mm (median 15 mm) at the corpus. Pelvic failure was identified in 22 patients with a 2-year pelvic disease-free survival rate of 75.6% but without evidence of failure at dwelling-skipped corpuses. CONCLUSION: Given after pelvic EBRT and ICRT of full-length dwelling in part, which may have eradicated possible subclinical extension, adjustment of the tandem-source dwell length to the MR-specified target volume appeared to be safe.
Authors: V Lorvidhaya; A Tonusin; W Changwiwit; I Chitapanarux; J Srisomboon; S Wanwilairat; N Chawapun; V Sukthomya Journal: Int J Radiat Oncol Biol Phys Date: 2000-03-15 Impact factor: 7.038
Authors: Richard Pötter; Christine Haie-Meder; Erik Van Limbergen; Isabelle Barillot; Marisol De Brabandere; Johannes Dimopoulos; Isabelle Dumas; Beth Erickson; Stefan Lang; An Nulens; Peter Petrow; Jason Rownd; Christian Kirisits Journal: Radiother Oncol Date: 2006-01-05 Impact factor: 6.280
Authors: Christine Haie-Meder; Richard Pötter; Erik Van Limbergen; Edith Briot; Marisol De Brabandere; Johannes Dimopoulos; Isabelle Dumas; Taran Paulsen Hellebust; Christian Kirisits; Stefan Lang; Sabine Muschitz; Juliana Nevinson; An Nulens; Peter Petrow; Natascha Wachter-Gerstner Journal: Radiother Oncol Date: 2005-03 Impact factor: 6.280
Authors: Johannes C A Dimopoulos; Gerdi Schard; Daniel Berger; Stefan Lang; Gregor Goldner; Thomas Helbich; Richard Pötter Journal: Int J Radiat Oncol Biol Phys Date: 2006-04-01 Impact factor: 7.038
Authors: K Togashi; K Nishimura; T Sagoh; S Minami; S Noma; I Fujisawa; Y Nakano; J Konishi; H Ozasa; I Konishi Journal: Radiology Date: 1989-04 Impact factor: 11.105