scholarly journals A dosimetric analysis of volumetric-modulated arc radiotherapy with jaw width restrictionvs7 field intensity-modulated radiotherapy for definitive treatment of cervical cancer

2014 ◽  
Vol 87 (1039) ◽  
pp. 20140183 ◽  
Author(s):  
B Huang ◽  
Z Fang ◽  
Y Huang ◽  
P Lin ◽  
Z Chen
2020 ◽  
Author(s):  
Mingfang Guo ◽  
Xueqi Ran ◽  
Dongling Zou ◽  
Na Zhang ◽  
Xianfeng Liu

Abstract Backgroud: To evaluate the dosimetric parameters, clinical complications, and efficacy of helical tomotherapy(HT) and fixed-field intensity-modulated radiotherapy (f-IMRT) in radical radiotherapy for cervical cancer.Methods: Between November 2016 and December 2018, 77 cervical cancer patients in radical irradiation were enrolled, 38 patients undergoing treatment with HT and 39 with f-IMRT. The dosimetry parameters, clinical complications, and efficacy were compared. Results: The HT plans had superior homogeneity index(HI) , conformity index(CI) (P=0.000),and resulted in a reduction in the dosimetry parameters of organs at risk(OARs) (P<0.05) except the V10 of small intestine (P=0.682).The incidence of myelosuppression showed no significant differences(P=0.265).The patients with HT had no radioactive cystitis, grade 2 or above rectal complication and acute bladder complication. The complete remission(CR) rates ,effective rates(CR+PR) and local control rates of two years were 81.58%,100% and 97.37%.Conclusion: The HT plans showed advantages in dosimetry, and provided more superior clinical outcomes.


2016 ◽  
Vol 11 (5) ◽  
pp. 3421-3427 ◽  
Author(s):  
YUNQIN LIU ◽  
JINMING YU ◽  
LITING QIAN ◽  
HONGYAN ZHANG ◽  
JUN MA

2012 ◽  
Vol 22 (7) ◽  
pp. 1220-1225 ◽  
Author(s):  
Guangyu Zhang ◽  
Chunli Fu ◽  
Youzhong Zhang ◽  
Jianbo Wang ◽  
Naian Qiao ◽  
...  

ObjectiveRetrospectively, to assess the toxicity of delivering postoperative extended-field intensity-modulated radiotherapy (EF-IMRT) and concurrent cisplatin chemotherapy for patients with cervical cancer with a pathologically confirmed positive common iliac node and/or a para-aortic node.MethodsEach patient received postoperative EF-IMRT and concurrent cisplatin chemotherapy. The clinical target volume included regional lymph node regions (obturator; common, internal, and external iliac nodal regions; presacral region; and para-aortic regions) and the upper 2.0 cm of the vagina and paravaginal soft tissue lateral to the vagina. The acute and late toxicity were scored using the Common Terminology Criteria for Adverse Events (CTCAE) and the Radiation Therapy Oncology Group late radiation morbidity scoring criteria, respectively.ResultsFifty-eight patients were treated with postoperative EF-IMRT and concurrent cisplatin chemotherapy. The median follow-up was 34 months. Eighteen patients (31%) had recurrence. The region of recurrence was in-field in 2 patients (3.4%) and out-field in 16 patients (27.6%). Acute grade 3 or higher gastrointestinal, genitourinary, and hematologic toxicity occurred in 2, 1, and 11patients, respectively. Three patients (5.1%) had late grade 3 toxicities. Thirteen patients experienced ovarian transposition; of these, 10 patients (77%) maintained ovarian function. Forty-one patients (71%) were alive at the last follow-up.ConclusionsConcurrent cisplatin chemotherapy with postoperative EF-IMRT was safe and well tolerated. The acute and late toxicities are acceptable. The locoregional control rates are hopeful, although distant metastases continue to be the primary mode of failure. Postoperative EF-IMRT provides an opportunity to preserve endocrine function for patients with ovarian transposition.


2014 ◽  
Vol 24 (5) ◽  
pp. 901-907 ◽  
Author(s):  
Ji-An Liang ◽  
Shang-Wen Chen ◽  
Yao-Ching Hung ◽  
Lian-Shung Yeh ◽  
Wei-Chun Chang ◽  
...  

ObjectiveThe objective of this study was to assess prospectively the clinical outcomes of low-dose prophylactic extended-field, intensity-modulated radiotherapy (IMRT) plus concurrent weekly cisplatin for patients with stage IB2-IIIB cervical cancer, positive pelvic lymph nodes (PLNs), and negative para-aortic lymph nodes (PALNs).MethodsThirty-two patients with stage IB2-IIIB cervical cancer with positive PLN and negative PALN were included prospectively. All lymph nodes were assessed with positron emission tomography. The PALN field, including lymphatics from the superior border of L1 to the L4-L5 interphase, was irradiated concurrently with pelvic IMRT with a prescribed dose of 40 Gy in 25 fractions. Chemotherapy consisted of cisplatin delivered weekly at a dose of 40 mg/m2. Using historical controls treated with pelvic radiotherapy, the survival curves were compared to assess the difference between the 2 treatment periods.ResultsThirty-one patients completed the allocated extended-field IMRT, and all finished the planned pelvic IMRT and brachytherapy. Acute ≥ grade 3 gastrointestinal, genitourinary, and hematologic toxicities were seen in 2, 1, and 18 patients, respectively. During a median follow-up of 33 months, 5 patients developed out-field distant recurrences. One patient had a late grade 3 gastrointestinal complication, and 1 patient had genitourinary toxicity. The 3-year actuarial overall survival, disease-free survival, and distant metastasis–free survival for the study cohort and historic controls were 87% versus 62% (P = 0.02), 82% versus 54% (P = 0.02), and 79% versus 57% (P = 0.01), respectively.ConclusionsExtended-field IMRT of 40 Gy to the PALN plus concurrent cisplatin can effectively eradicate subclinical disease at the PALN and improve the outcome for patients with PLN-positive stage IB2-IIIB cervical cancer.


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