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Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute
PURPOSE: To record and report dosimetric and clinical outcomes of interstitial brachytherapy using cobalt-60 ((60)Co) source in cervical cancer. MATERIAL AND METHODS: Seventy patients who underwent external beam radiotherapy with dose of 45 Gy in 25 fractions, followed by interstitial brachytherapy...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690231/ https://www.ncbi.nlm.nih.gov/pubmed/33293974 http://dx.doi.org/10.5114/jcb.2020.98114 |
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author | Kumar, Mohan Thangaraj, Revathy Alva, Ram Charith Koushik, Kirthi Ponni, Arul Janaki, Manur Gururajachar |
author_facet | Kumar, Mohan Thangaraj, Revathy Alva, Ram Charith Koushik, Kirthi Ponni, Arul Janaki, Manur Gururajachar |
author_sort | Kumar, Mohan |
collection | PubMed |
description | PURPOSE: To record and report dosimetric and clinical outcomes of interstitial brachytherapy using cobalt-60 ((60)Co) source in cervical cancer. MATERIAL AND METHODS: Seventy patients who underwent external beam radiotherapy with dose of 45 Gy in 25 fractions, followed by interstitial brachytherapy (ISBT) 6.5 Gy × 4 fractions were included into this study. The ISBT applicators were inserted under combined spinal and epidural anesthesia. Computed tomography (CT) simulation was performed and axial CT images were transferred to treatment planning system. High-risk clinical target volume (CTV(HR)) and organs at risks (OARs) were contoured. Four fractions of 6.5 Gy were prescribed to CTV(HR) using inverse planning technique. Patients were followed-up for 3 years. Dosimetric parameters and clinical outcomes were recorded and compared with available literature. RESULTS: Seventy patients with FIGO stage IIB-IVA were included in the study. The median EQD(2) of 2 cm(3) of bladder, rectum, sigmoid and D(90) CTV(HR) were 70 Gy (53-75 Gy), 64 Gy (51-71 Gy), 48 Gy (44-72 Gy), and 77 Gy (70-86 Gy), and dose homogeneity index (DHI), dose non-uniformity ratio (DNR), coverage index (CI), overdose volume index (OI), and conformal index (COIN) were 0.58 (0.39-0.78), 0.42 (0.22-0.61), 0.87 (0.59-0.97), 0.19 (0.09-0.30) and 0.74 (0.52-0.85), respectively. Local control rate at 2 years was 87.14%. Eight patients had local recurrence and one patient had lung metastasis. Also, two patients with local recurrence had recto-vaginal fistula. Two patients had grade 2 proctitis (2.8%) and one patient developed grade 3 proctitis (1.4%). There was no grade 2 or higher bladder toxicity. CONCLUSIONS: The dosimetric parameters, local control and toxicities of high-dose-rate interstitial brachytherapy in cervical cancer patients treated by (60)Co radioactive source are similar, compared to available literature using iridium-192 ((192)Ir) source. |
format | Online Article Text |
id | pubmed-7690231 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-76902312020-12-07 Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute Kumar, Mohan Thangaraj, Revathy Alva, Ram Charith Koushik, Kirthi Ponni, Arul Janaki, Manur Gururajachar J Contemp Brachytherapy Original Paper PURPOSE: To record and report dosimetric and clinical outcomes of interstitial brachytherapy using cobalt-60 ((60)Co) source in cervical cancer. MATERIAL AND METHODS: Seventy patients who underwent external beam radiotherapy with dose of 45 Gy in 25 fractions, followed by interstitial brachytherapy (ISBT) 6.5 Gy × 4 fractions were included into this study. The ISBT applicators were inserted under combined spinal and epidural anesthesia. Computed tomography (CT) simulation was performed and axial CT images were transferred to treatment planning system. High-risk clinical target volume (CTV(HR)) and organs at risks (OARs) were contoured. Four fractions of 6.5 Gy were prescribed to CTV(HR) using inverse planning technique. Patients were followed-up for 3 years. Dosimetric parameters and clinical outcomes were recorded and compared with available literature. RESULTS: Seventy patients with FIGO stage IIB-IVA were included in the study. The median EQD(2) of 2 cm(3) of bladder, rectum, sigmoid and D(90) CTV(HR) were 70 Gy (53-75 Gy), 64 Gy (51-71 Gy), 48 Gy (44-72 Gy), and 77 Gy (70-86 Gy), and dose homogeneity index (DHI), dose non-uniformity ratio (DNR), coverage index (CI), overdose volume index (OI), and conformal index (COIN) were 0.58 (0.39-0.78), 0.42 (0.22-0.61), 0.87 (0.59-0.97), 0.19 (0.09-0.30) and 0.74 (0.52-0.85), respectively. Local control rate at 2 years was 87.14%. Eight patients had local recurrence and one patient had lung metastasis. Also, two patients with local recurrence had recto-vaginal fistula. Two patients had grade 2 proctitis (2.8%) and one patient developed grade 3 proctitis (1.4%). There was no grade 2 or higher bladder toxicity. CONCLUSIONS: The dosimetric parameters, local control and toxicities of high-dose-rate interstitial brachytherapy in cervical cancer patients treated by (60)Co radioactive source are similar, compared to available literature using iridium-192 ((192)Ir) source. Termedia Publishing House 2020-08-21 2020-08 /pmc/articles/PMC7690231/ /pubmed/33293974 http://dx.doi.org/10.5114/jcb.2020.98114 Text en Copyright © 2020 Termedia http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/) |
spellingShingle | Original Paper Kumar, Mohan Thangaraj, Revathy Alva, Ram Charith Koushik, Kirthi Ponni, Arul Janaki, Manur Gururajachar Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title | Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title_full | Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title_fullStr | Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title_full_unstemmed | Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title_short | Interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
title_sort | interstitial high-dose-rate brachytherapy using cobalt-60 source for cervical cancer: dosimetric and clinical outcomes from a single institute |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690231/ https://www.ncbi.nlm.nih.gov/pubmed/33293974 http://dx.doi.org/10.5114/jcb.2020.98114 |
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