Fei Li1, Shuangchen Lu2, Hongfu Zhao3, Xin Mu4, Zhuang Mao1. 1. Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun City, PR China. 2. Department of Radiation Oncology, The Second Hospital of Jilin University, Changchun City, PR China. 3. Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun City, PR China. Electronic address: zhaohf@jlu.edu.cn. 4. Department of Radiation Oncology, Jilin City Hospital of Chemical Industry, Jilin City, PR China.
Abstract
PURPOSE: To evaluate the local control and toxicities of three-dimensional image-guided combined intracavitary and interstitial (IC/IS) high-dose-rate brachytherapy (BT) in cervical cancer through a systematic review. METHODS AND MATERIALS: A systematic review of relevant studies was performed through the PubMed, Web of Science, and Cochrane Library databases through May 10, 2020. Articles reporting on IC/IS technology, volumetric doses to high-risk clinical target volume (HR-CTV) and organs at risk (OARs), tumor control and/or treatment-related side effects were identified. The key information, including the type of applicator, implantation technology, characteristics of implantation, volumetric doses, tumor control, and/or treatment-related side effects, was extracted. A probit model analysis between HR-CTV D90 and tumor local control was performed. RESULTS: Twelve studies encompassing 520 patients were included in the probit model between HR-CTV D90 and the local control rate. The probit model showed a significant relationship between the HR-CTV D90 value and the local control probability, p = 0.003. The prescribed dose of 85 GyEQD2,10 would in theory warrant an 87.4% (95% confidence interval 82.5%-90.5%) local control rate. CONCLUSION: IC/IS BT is an appropriate method to achieve a high therapeutic ratio for tumors with large volumes or poor responses after external irradiation in cervical cancer. The probit model showed that the dose escalation of HR-CTV D90 was helpful to improve the local tumor control rate.
PURPOSE: To evaluate the local control and toxicities of three-dimensional image-guided combined intracavitary and interstitial (IC/IS) high-dose-rate brachytherapy (BT) in cervical cancer through a systematic review. METHODS AND MATERIALS: A systematic review of relevant studies was performed through the PubMed, Web of Science, and Cochrane Library databases through May 10, 2020. Articles reporting on IC/IS technology, volumetric doses to high-risk clinical target volume (HR-CTV) and organs at risk (OARs), tumor control and/or treatment-related side effects were identified. The key information, including the type of applicator, implantation technology, characteristics of implantation, volumetric doses, tumor control, and/or treatment-related side effects, was extracted. A probit model analysis between HR-CTV D90 and tumor local control was performed. RESULTS: Twelve studies encompassing 520 patients were included in the probit model between HR-CTV D90 and the local control rate. The probit model showed a significant relationship between the HR-CTV D90 value and the local control probability, p = 0.003. The prescribed dose of 85 GyEQD2,10 would in theory warrant an 87.4% (95% confidence interval 82.5%-90.5%) local control rate. CONCLUSION: IC/IS BT is an appropriate method to achieve a high therapeutic ratio for tumors with large volumes or poor responses after external irradiation in cervical cancer. The probit model showed that the dose escalation of HR-CTV D90 was helpful to improve the local tumor control rate.