Definitive radiotherapy consisting of external beam radiotherapy without central shielding and 3D image-guided brachytherapy for patients with cervical cancer: feasibility for Japanese patients and dose-response analyses for local control in the low-dose range

To assess the feasibility of external beam radiotherapy without central shielding in definitive radiotherapy for Japanese patients with cervical cancer. We retrospectively analysed the data of cervical cancer patients treated with definitive radiotherapy consisting of external beam radiotherapy with...

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Published in:Japanese journal of clinical oncology 2023-06, Vol.53 (6), p.480-488
Main Authors: Toita, Takafumi, Wada, Kentaro, Sutani, Shinya, Umezawa, Rei, Maemoto, Hitoshi, Ii, Noriko, Kawamura, Tomoko, Ikushima, Hitoshi, Takenaka, Ryosuke, Konishi, Koji, Yorozu, Atsunori, Jingu, Keiichi, Ariga, Takuro, Nomoto, Yoshihito, Yamashita, Hideomi
Format: Article
Language:English
Subjects:
Brachytherapy
East Asian People
Feasibility Studies
Female
Humans
Radiotherapy Dosage
Radiotherapy, Image-Guided
Retrospective Studies
Treatment Outcome
Uterine Cervical Neoplasms - radiotherapy
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Summary:To assess the feasibility of external beam radiotherapy without central shielding in definitive radiotherapy for Japanese patients with cervical cancer. We retrospectively analysed the data of cervical cancer patients treated with definitive radiotherapy consisting of external beam radiotherapy without central shielding and three-dimensional-image-guided brachytherapy. The study included 167 patients (T1 + 2 = 108, T3 + 4 = 59) from eight Japanese institutions. For three-dimensional-image-guided brachytherapy, intra-cavitary and interstitial brachytherapy was utilized in 33 patients (20%). The median follow-up was 26.6 months (interquartile range, 20-43.2). The maximum rectal D2 (75 Gy)/bladder D2 (90 Gy) constraints were deviated by 6%/10% and 10%/5% for T1 + 2 and T3 + 4, respectively. The 2-year incidence of ≥grade 3 proctitis/cystitis was 4%/1% for T1 + 2 and 10%/2% for T3 + 4. The 2-year local progression-free survival was 89% for T1 + 2 and 82% for T3 + 4. For T1 + 2, the 2-year local progression-free survival for the high-risk clinical target volume D90 ≥ 68 Gy (indicated by receiver operating characteristic analysis; area under the curve = 0.711) was 92% versus 67% for
ISSN:1465-3621
1465-3621
DOI:10.1093/jjco/hyad022