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Clinical outcomes of conventional HDR intracavitary brachytherapy combined with complementary applicator-guided intensity modulated radiotherapy boost in patients with bulky cervical tumor
  • +12
  • Shun Lu,
  • Shubin Wang,
  • Robert Y Kim,
  • Jiayu Zhang,
  • Xianliang Wang,
  • Weidong Wang,
  • Guiquan Zhu,
  • Jie Zhou,
  • Yan Tan,
  • Mingyu Tan,
  • Minglun Li,
  • Gang Yin,
  • Jie Li,
  • Mei Feng,
  • Jinyi Lang
Shun Lu
Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, Radiation Oncology Key Laboratory Of Sichuan Province

Corresponding Author:lushun1982@live.cn

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Shubin Wang
University of Electronic Science and Technology of China School of Medicine
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Robert Y Kim
University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
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Jiayu Zhang
University of Electronic Science and Technology of China School of Medicine, School of Medicine No.2006, Xiyuan Avenue, High‑Tech Zone (West District),
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Xianliang Wang
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Weidong Wang
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Guiquan Zhu
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Jie Zhou
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Yan Tan
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Mingyu Tan
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Minglun Li
University Hospital, LMU Munich, Munich, Germany
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Gang Yin
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Jie Li
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Mei Feng
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Jinyi Lang
Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China, 2Radiation Oncology Key Laboratory of Sichuan Province,
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Abstract

Objective To investigate the clinical outcomes and toxicity in patients with locally advanced cervical cancer treated with supplementary applicator guided-intensity modulated radiation therapy (IMRT) based on conventional intracavitary brachytherapy (IC/IMRT). Population Large high risk clinical target volume (HR-CTV) volume (>40cc) at the time of brachytherapy cervical cancer patients were recruited. Methods This study is a retrospective analysis of 76 patients with locally advanced cervical cancer (FIGO IIB-IVA) treated with concurrent chemo-radiotherapy followed by IC/IMRT between June 2010 and October 2016. External radiotherapy (45 Gy in 25 fractions) with cisplatin chemotherapy treated before IC/IMRT. The prescription dose for HR-CTV and IR-CTV were 6 Gy and 5 Gy per fraction for 5 fractions respectively. Results: Mean HR-CTV was 65.8±23.6 cc at the time of brachytherapy. D90 for HR-CTV and IR-CTV were 88.7±3.6 Gy and 78.1±2.5 Gy. D2cc for bladder, rectum, sigmoid and small intestine were 71.8±3.8 Gy, 64.6±4.9 Gy, 63.9±5.3 Gy and 56.7±8.7 Gy respectively. Median follow-up was 85 months (47.9-124.2 months). Five-year local recurrence free survival rate, metastasis recurrence free survival rate, disease free survival rate and cancer special survival rate were 87.6%, 82.4%, 70.9% and 76.3%, respectively. The grade 1+2 gastrointestinal and urinary late toxicities were 15.8% and 21.1%, while grade 3 late toxicities were 3.9% and 5.2%, respectively. Neither acute nor late grade 4 gastrointestinal or urinary toxicities were seen. Conclusions: The combination of ICBT with an applicator-guided supplementary IMRT boost achieved an excellent local control and overall survival with low toxicity for bulky residual cervical tumor
26 Apr 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
27 Apr 2022Submission Checks Completed
27 Apr 2022Assigned to Editor
12 May 2022Reviewer(s) Assigned
14 Jun 2022Review(s) Completed, Editorial Evaluation Pending
11 Jul 2022Editorial Decision: Revise Major
23 Jul 20221st Revision Received
04 Aug 2022Submission Checks Completed
04 Aug 2022Assigned to Editor
04 Aug 2022Review(s) Completed, Editorial Evaluation Pending
24 Sep 2022Editorial Decision: Revise Minor
29 Sep 20222nd Revision Received
30 Sep 2022Submission Checks Completed
30 Sep 2022Assigned to Editor
30 Sep 2022Review(s) Completed, Editorial Evaluation Pending
17 Oct 2022Editorial Decision: Accept