Dose rate in the highest irradiation area of the rectum correlates with late rectal complications in patients treated with high-dose-rate computed tomography-based image-guided brachytherapy for cervical cancer
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- Fumiaki Isohashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Yuichi Akino
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Yuri Matsumoto
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Osamu Suzuki
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Yuji Seo
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Keisuke Tamari
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Iori Sumida
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Kenjiro Sawada
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Yutaka Ueda
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Eiji Kobayashi
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Takuji Tomimatsu
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Erina Nakanishi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Takahisa Nishi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Tadashi Kimura
- Department of Gynecology and Obstetrics, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
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- Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
説明
<jats:title>Abstract</jats:title> <jats:p>The purpose of this study was to evaluate the effect of dose rate to the rectum on late rectal complications in patients treated with computed tomography (CT)-based image-guided brachytherapy (IGBT) for cervical cancer. The subjects were 142 patients with cervical cancer who underwent Ir-192 high-dose-rate (HDR)-IGBT between March 2012 and January 2018. The dose rate to the rectum was calculated using in-house software. The minimum, mean and maximum effective dose rate (EDR) was calculated for voxels of the rectal volume covered by cumulative doses >D0.1cc, >D2cc, and > D5cc. The average EDR of three to four brachytherapy sessions was calculated (EDR for patients; EDRp). The total dose of the rectum was calculated as the biologically equivalent dose in 2-Gy fractions (EQD2). The associations between EDRp for D0.1cc, D2cc, and D5cc and the respective rectal EQD2 values with late rectal complications were then analyzed. The median follow-up period was 40 months. Patients with rectal complications of ≥Grade 1 received a significantly higher mean EDRp for D0.1cc–5cc and had a greater EQD2 for D0.1cc–5cc. Multivariate analysis was performed using the mean EDRp for D2cc, EQD2 for D2cc, heavy smoking and BMI. Of these four variables, mean EDRp for D2cc (HR = 3.38, p = 0.004) and EQD2 for D2cc (HR = 2.59, p = 0.045) emerged as independent predictors for late rectal complications. In conclusion, mean EDRp and EQD2 were associated with late rectal complications in patients treated with HDR CT-based IGBT for cervical cancer.</jats:p>
収録刊行物
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- Journal of Radiation Research
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Journal of Radiation Research 62 (3), 494-501, 2021-04-19
Oxford University Press (OUP)
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詳細情報 詳細情報について
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- CRID
- 1360857593778717184
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- ISSN
- 13499157
- 04493060
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- データソース種別
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- Crossref
- KAKEN