Abdominal Tumor
A comparative study of positron emission tomography-computed tomography and computed tomography image-guided radiotherapy for cervical cancer with retroperitoneal node metastasis
Jusheng An, Yingjie Xu, Xiaomeng Du, Wenjie Zhang, Jianrong Dai, Rong Zheng, Manni Huang, Lingying Wu, Ning Wu
Published 2016-09-15
Cite as Chin J Radiat Oncol, 2016, 25(9): 944-948. DOI: 10.3760/cma.j.issn.1004-4221.2016.09.007
Abstract
ObjectiveTo evaluate the feasibility of using positron emission tomography-computed tomography (PET-CT) to guide lesion localization and radiotherapy planning for stage ⅡB-IVA cervical cancer with retroperitoneal node metastasis.
MethodsBefore treatment, PET-CT was used for staging and lesion localization. Three-dimensional radiotherapy (3DRT) plans with boost doses for metastatic lymph nodes were made based on the fused PET-CT images. The obtained plans were compared with CT image-guided plans within the same period. Comparison was made by paired t test or non-parametric test.
ResultsThe PET-CT plans had significantly larger GTVnd, pGTVnd, CTV, and PTV than the CT plans (P=0.012, 0.010, 0.018, 0.018). There were no significant differences in V40, V50, or D1 cm3 for the small intestine between the two plans (P=0.744, 0.588, 0.423). The PET-CT plans had significantly lower V20, V30, and Dmean for the small intestine than the CT plans (68.1% vs. 74.5%, P=0.020; 36.1% vs. 39.6%, P=0.016; 2 546.1 vs. 2 761.4 Gy, P=0.036). Moreover, the PET-CT plans had significantly larger V20 and Dmean for the kidney than the CT plans (9.4% vs. 5.7%, P=0.006; 877.0 vs. 733.8 Gy, P=0.005). There were no significant differences in V30 and V40 for the kidney or Dmean for the rectum, bladder, colon, pelvic bone, bone marrow, and femoral head between the two plans (P=0.089, 0.341, 0.406, 0.107, 0.178, 0.397, 0.285, 0.743).
ConclusionsIt is feasible to use fused PET-CT images to guide external 3DRT plans, which can accurately localize the metastatic lymph nodes and elevate the radiation dose. However, the protection of the small intestine and kidney should be taken into account.
Key words:
Tomography, positron emission; Cervical neoplasms/three-dimensional radiotherapy; Retroperitoneal nodes metastasis
Contributor Information
Jusheng An
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Yingjie Xu
Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Xiaomeng Du
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Wenjie Zhang
Department of PET-CT, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Jianrong Dai
Department of Radiation Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Rong Zheng
Department of PET-CT, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Manni Huang
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Lingying Wu
Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Ning Wu
Department of PET-CT, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China