Dose Volume Analysis of Radiotherapy for Inoperable Patients with Stage I-II Endometrial Carcinoma

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概要

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• This study aims to assess the efficacy and toxicity of definitive radiotherapy for early-stage endometrial carcinoma. The correlation between CT-based dosimetric parameters and clinical outcomes is also evaluated. Between 2002 and 2006, 10 medically inoperable patients with T1-2 endometrial carcinoma were treated with radiotherapy alone. A combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) was used for 9 patients, and one was treated with HDR-ICBT alone. Dose prescription of HDR-ICBT was determined in reference to CT images at brachytherapy, and a total dose of 22–24 Gy in 4 fractions was delivered to the outer perimeter of the uterine corpus. Dose-volume parameters of the gross tumor volume (GTV), clinical target volume (CTV), and organs at risk were assessed retrospectively using the dose-volume histograms derived from the CT image-based treatment planning system. After a median follow-up of 55 months, 9 patients were alive without evidence of recurrence. One patient died from liver cirrhosis 17 months after radiotherapy. Severe acute and late toxicities were not observed in any of the patients. Average minimum dose to 90% of GTV and CTV (D90) was 88.0 and 45.9 GyEQD2, respectively. The minimum dose delivered to 2 cc of the most irradiated volumes of the rectum and sigmoid colon (D2cc) was 78.9 and 65.9 GyEQD2, respectively. These patients developed Grade 1 late complications. In this study, stage I–II endometrial carcinoma was well-controlled locally with minimum late toxicity by radiotherapy alone with HDR-ICBT. 3D image-based brachytherapy may potentially deliver a sufficiently high dose to the whole tumor without significant increase in dose to surrounding normal tissues.

• 2011-09-16

著者

• KIYOHARA Hiroki

  Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences

• TAKAHASHI Takeo

  Department of Radiation Oncology, Gunma University Graduate school of Medicine

• 鈴木 和美

  Showa College of Pharmaceutical Sciences

• Ohno Tatsuya

  放射線医学総合研究所重粒子医科学センター病院

• Suzuki Kazutoshi

  放射線医学総合研究所分子イメージング研究センター

• NODA Shin-ei

  Department of Radiation Oncology, Gunma University Graduate School of Medicine

• Suzuki K

  Pharmaceutical Frontier Research Laboratories Japan Tobacco Inc.

• Noda Shin-ei

  Department Of Radiation Oncology Gunma University Graduate School Of Medicine

• Nakano T

  Centrifuge Project Team Nasda

• Nakano Takashi

  Department Of Anatomy Aichi Medical University

• Nakano Takashi

  Department Of Radiology And Radiation Oncology Gunma University Graduate School Of Medicine

• Suzuki K

  Noda Research Laboratories Drug Delivery System Institute Ltd.:(present Address)pharmaceutics Resear

• Kato Hirotoshi

  Research Center Hospital For Charged Particle Therapy National Institute Of Radiological Sciences

• Kato Shingo

  Research Center Hospital For Charged Particle Therapy National Institute Of Radiological Sciences

• Ohno Tatsuya

  Gunma University Heavy Ion Medical Center Gunma University Graduate School Of Medicine

• Tamaki Tomoaki

  Department Of Radiation Oncology Gunma University Graduate School Of Medicine

• Suzuki Kazutoshi

  Department Of Medical Imaging National Institute Of Radiological Sciences

• Suzuki Kazutoshi

  Clinical Neuroimaging Section Department Of Molecular Neuroimaging Molecular Imaging Center National

• Taketomi Takahashi

  Department Of Diagnostic Radiology And Nuclear Medicine Gunma University Graduate School Of Medicine

• Suzuki K

  Molecular Imaging Center National Institute Of Radiological Sciences

• Ohkubo Yu

  Research Center Hospital For Charged Particle Therapy National Institute Of Radiological Sciences

• Nonaka Tetsuo

  Department Of Radiation Oncology Gunma University Graduate School Of Medicine

• Nonaka Tetsuo

  Department Of Radiology Gunma Cancer Center

• Ohta Toshie

  Radgenomics Research Group National Institute Of Radiological Sciences

• Tanaka Naritaka

  Department Of General Surgical Science (surgery I) Gunma University Graduate School Of Medicine

• Ohno Tatsuya

  Department Of Radiation Oncology Graduate School Of Medicine Gunma University

• OHKUBO Yu

  Hidaka Hospital

• TSURUOKA Ichiro

  Research Center for Charged Particle Therapy, National Institute of Radiological Sciences

• TAMAKI Tomoaki

  Applied Radiation Biology and Radiotherapy Section, International Atomic Energy Agency

• Nakazawa Tsugio

  Department Of Tumor Pathology Gunma University Graduate School Of Medicine

• Takahashi T

  Department Of Radiation Oncology Gunma University Graduate School Of Medicine

• Kato Shingo

  Research Center For Charged Particle Therapy National Institute Of Radiological Sciences

• Tsuruoka Ichiro

  Research Center For Charged Particle Therapy National Institute Of Radiological Sciences

• Kato Hiroyuki

  Department Of Radiation Oncology Gunma University Graduate School Of Medicine

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