Abdominal Tumor
The clinical application research of Utrecht applicator in three-dimensional image guided brachytherapy (3D-IGBT) for cervical cancer
Zhipeng Zhao, Ning Zhang, Guanghui Cheng, Mingyuan He, Dan Shi, Hongfu Zhao
Published 2016-09-15
Cite as Chin J Radiat Oncol, 2016, 25(9): 950-954. DOI: 10.3760/cma.j.issn.1004-4221.2016.09.009
Abstract
ObjectiveTo investigate the clinical application of Utrecht applicator in three-dimensional image-guided brachytherapy (3D-IGBT) for locally advanced cervical cancer, as well as its application discipline in intracavitary/interstitial (IC/IS) therapy.
MethodsA retrospective analysis was performed for the clinical data of 45 patients with locally advanced cervical cancer who received radical radiotherapy, and the patients received external beam radiotherapy followed by 3D-IGBT. A total of 130 times (n=45) of IC/IS therapy were performed, and the patients who received such therapy were all enrolled. The patients who met the target dose fractionation defined in the plan were enrolled as group A (n=37, 86 times), and the other patients were enrolled as group B (n=22, 44 times). Two groups difference was analyzed with Group t-test.
ResultsThe frequencies of use of 15-, 20-, and 25-mm ovoids by the applicator were 50.0%, 20.0%, and 30.0%, respectively, and the 30-mm ovoid was not used. A total of 499 needles were used, and the frequencies of use of 6, 7, 10, and 11 insertion holes were 23.1%, 21.2%, 21.2%, and 24.1%, respectively. Group A had a significantly lower mean number of the needles than group B (3.7 vs. 4.2, P=0.008). Compared with group B, group A had a significantly lower mean high-risk clinical target volume (CTV)(40.71±18.43 cm3vs. 51.81±14.74 cm3, P=0.001), as well significantly lower width and height of high-risk CTV (P=0.011 and 0.006), but the thickness of high-risk CTV was similar between the two groups (P=0.595). The difference between height and insertion depth (DH) was similar between the two groups (P=0.366). Group A had a smaller difference between width and pinhole distance Dw than group B (P=0.007).
ConclusionsWhen IC/IS therapy is performed for locally advanced cervical cancer, the 15-, 20-, and 25-mm ovoids of Utrecht applicator and 6, 7, 10, and 11 insertion holes are frequently used. When the number of needles is no less than 4 and the depth is no less than 3 cm, width is the major factor which affects the planned dose.
Key words:
Cervical neoplasms/brachytherapy; Brachytherapy, three-dimentional image quided; Utrecht applicator; Interstitial /interstitial; Planning aim dose
Contributor Information
Zhipeng Zhao
Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun 130000, China
Ning Zhang
Guanghui Cheng
Mingyuan He
Dan Shi
Hongfu Zhao
