Warren Bacorro1, Isabelle Dumas2, Antonin Levy3, Eleonor Rivin Del Campo3, Charles-Henri Canova3, Tony Felefly3, Andres Huertas3, Fanny Marsolat2, Christine Haie-Meder3, Cyrus Chargari4, Renaud Mazeron3. 1. Department of Radiation Oncology, Brachytherapy Unit, Gustave Roussy, University of Paris Saclay, Villejuif, France; Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, Manila, Philippines. Electronic address: WARREN.BACORRO@gustaveroussy.fr. 2. Department of Medical Physics, Gustave Roussy, University of Paris Saclay, Villejuif, France. 3. Department of Radiation Oncology, Brachytherapy Unit, Gustave Roussy, University of Paris Saclay, Villejuif, France. 4. Department of Radiation Oncology, Brachytherapy Unit, Gustave Roussy, University of Paris Saclay, Villejuif, France; Institut de Recherche Biomédicale des Armées, Bretigny-sur-Orge, France; French Military Health Academy, Ecole du Val-de-Grâce, Paris, France.
Abstract
PURPOSE: With the increasing use of simultaneous integrated boost in the treatment of cervical cancer, there is a need to anticipate the brachytherapy (BT) contribution at the level of the pathologic pelvic lymph nodes. This study aimed to report the dose delivered at their level during BT. METHODS AND MATERIALS: Patients with pelvic nodal involvement and treated with a combination of chemoradiation followed by image-guided adaptive pulsed-dose-rate BT were selected. On per BT three-dimensional images, pelvic lymphadenopathies were delineated, without planning aim. For the purposes of the study, D100, D98, D90, and D50 were reviewed and converted in 2-Gy equivalent doses, using the linear quadratic model with an α/β of 10 Gy. RESULTS: Ninety-one patients were identified, allowing evaluation at the level of 226 lymphadenopathies. The majority of them were external iliac (48%), followed by common iliac (25%), and internal iliac (16%) regions. The 2-Gy equivalent doses D98 were 4.4 ± 1.9 Gy, 5.4 ± 3.1 Gy, and 4.3 ± 2.1 Gy for the obturator, internal iliac, and external iliac, respectively, and 2.8 ± 2.5 Gy for the common iliac. The contribution to the common iliac nodes was significantly lower than the one of external and internal iliac (p < 0.001). CONCLUSIONS: BT significantly contributes to the treatment of pelvic nodes at the level of approximately 5 Gy in the internal, external, and obturator areas and 2.5 Gy in the common iliac, allowing the anticipation of nodal boost with the simultaneous integrated boost technique. However, important individual variations have been observed, and evaluation of the genuine BT contribution should be recommended.
PURPOSE: With the increasing use of simultaneous integrated boost in the treatment of cervical cancer, there is a need to anticipate the brachytherapy (BT) contribution at the level of the pathologic pelvic lymph nodes. This study aimed to report the dose delivered at their level during BT. METHODS AND MATERIALS: Patients with pelvic nodal involvement and treated with a combination of chemoradiation followed by image-guided adaptive pulsed-dose-rate BT were selected. On per BT three-dimensional images, pelvic lymphadenopathies were delineated, without planning aim. For the purposes of the study, D100, D98, D90, and D50 were reviewed and converted in 2-Gy equivalent doses, using the linear quadratic model with an α/β of 10 Gy. RESULTS: Ninety-one patients were identified, allowing evaluation at the level of 226 lymphadenopathies. The majority of them were external iliac (48%), followed by common iliac (25%), and internal iliac (16%) regions. The 2-Gy equivalent doses D98 were 4.4 ± 1.9 Gy, 5.4 ± 3.1 Gy, and 4.3 ± 2.1 Gy for the obturator, internal iliac, and external iliac, respectively, and 2.8 ± 2.5 Gy for the common iliac. The contribution to the common iliac nodes was significantly lower than the one of external and internal iliac (p < 0.001). CONCLUSIONS: BT significantly contributes to the treatment of pelvic nodes at the level of approximately 5 Gy in the internal, external, and obturator areas and 2.5 Gy in the common iliac, allowing the anticipation of nodal boost with the simultaneous integrated boost technique. However, important individual variations have been observed, and evaluation of the genuine BT contribution should be recommended.
Authors: Hayeon Kim; Yongsook C Lee; Stanley H Benedict; Brandon Dyer; Michael Price; Yi Rong; Ananth Ravi; Eric Leung; Sushil Beriwal; Mark E Bernard; Jyoti Mayadev; Jessica R L Leif; Ying Xiao Journal: Int J Radiat Oncol Biol Phys Date: 2021-06-17 Impact factor: 7.038
Authors: T Kumar; A Schernberg; F Busato; M Laurans; I Fumagalli; I Dumas; E Deutsch; C Haie-Meder; C Chargari Journal: Cancer Manag Res Date: 2019-07-08 Impact factor: 3.989