Impact of dosimetric parameters on local control for patients treated with three-dimensional pulsed dose-rate brachytherapy for cervical cancer

• Published in: Brachytherapy Vol. 13; no. 4; pp. 326 - 331
• Main Authors: Boyrie, Sabrina, Charra-Brunaud, Claire, Harter, Valentin, Ducassou, Anne, Kirova, Youlia, Barillot, Isabelle, Krzisch, Claude, Lang, Philippe, Baron, Marie-Hélène, Montbarbon, Xavier, Delannes, Martine, Peiffert, Didier
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2014; Elsevier
• Subjects: Adenocarcinoma; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - mortality; Adenocarcinoma - radiotherapy; Adult; Aged; Aged, 80 and over; Brachytherapy; Brachytherapy - methods; Carcinoma, Squamous Cell; Carcinoma, Squamous Cell - diagnostic imaging; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - radiotherapy; Cervical cancer; Dose-Response Relationship, Radiation; Female; Follow-Up Studies; Hematology, Oncology, and Palliative Medicine; Humans; Imaging, Three-Dimensional; Life Sciences; Local control; Magnetic Resonance Imaging; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Recurrence, Local - etiology; Prospective Studies; Pulsed dose-rate brachytherapy; Radiology; Radiotherapy Dosage; Risk Factors; Santé publique et épidémiologie; Survival Analysis; Three-dimensional brachytherapy; Tomography, X-Ray Computed; Treatment Outcome; Uterine Cervical Neoplasms; Uterine Cervical Neoplasms - diagnostic imaging; Uterine Cervical Neoplasms - mortality; Uterine Cervical Neoplasms - radiotherapy; Pulsed dose-rate brachytherapy; Local control; Three-dimensional brachytherapy; Cervical cancer
• ISSN: 1538-4721; 1873-1449; 1873-1449
• DOI: 10.1016/j.brachy.2014.03.003

To investigate the impact of dose-volume histograms parameters on local control of three-dimensional (3D) image-based pulsed dose-rate brachytherapy (BT). Within a French multicentric prospective study, the data of the 110 patients treated for cervical cancer with external beam radiotherapy followed by 3D image-based and optimized pulsed dose-rate BT were analyzed. Delineation procedures were performed on magnetic resonance imaging in a minority of cases and on CT for the majority of cases, adapted from the Gynaecological Groupe Européen de Curiethérapie—European Society for Therapeutic Radiology and Oncology recommendations. Optimization procedure was left to the discretion of the treating center. At 2 years, local control rate reached 78%. Dose to Point A, total reference air kerma, and intermediate-risk clinical target volume (IR-CTV) V60 were predictive factors for local control (p = 0.001, p = 0.001, and p = 0.013, respectively). Patients with IR-CTV V60 <75% had a relative risk of local recurrence of 3.8 (95% confidence interval, 1.4–11.1). There was no correlation found between the high-risk clinical target volume dosimetric parameters and local control. This multicentric study has shown that 3D image-based BT provides a high local control rate for cervical cancer patients. The V60 for IR-CTV was identified as an important predictive factor for local control.