RESUMO
OBJECTIVES: To report the intermediate-term results of trans-abdominal ultrasound (TAUS)-guided brachytherapy in cervical cancer. MATERIALS AND METHODS: Ninety-two patients with cervical cancer (stage IB-IVA, according to FIGO staging), were treated by curative radiotherapy from February 2012 to June 2015. All patients were treated with whole pelvic radiotherapy to 50â¯Gy in 25 fractions and central shielding after 44â¯Gy, in combination with TAUS-guided brachytherapy, in order to escalate the total dose (EQD2) to the minimal dose at cervical points (in EQD2 concepts) defined by TAUS, while maintaining low doses to ICRU bladder and rectal points. The treatment results and toxicity profiles were reported. RESULTS: At median follow-up time of 41.2â¯months (range 8 to 61â¯months) the pelvic control, disease-free survival, and overall survival rates were 84.8%, 75%, and 88%, respectively. The mean applied doses to cervix, bladder, and rectal points were 83.5, 72.3, and 76.5â¯Gy, respectively. Eight patients developed grade 2 Gastrointestinal toxicity. CONCLUSION: The 3-year results demonstrated that TAUS-guided brachytherapy is feasible and associated with excellent tumor control/toxicity rates in cervical cancer.
Assuntos
Adenocarcinoma/terapia , Braquiterapia/métodos , Carcinoma de Células Escamosas/terapia , Radioterapia Guiada por Imagem/métodos , Neoplasias do Colo do Útero/terapia , Adenocarcinoma/patologia , Adulto , Idoso , Antineoplásicos/uso terapêutico , Carboplatina/uso terapêutico , Carcinoma de Células Escamosas/patologia , Quimiorradioterapia/métodos , Cisplatino/uso terapêutico , Intervalo Livre de Doença , Feminino , Humanos , Pessoa de Meia-Idade , Pelve , Dosagem Radioterapêutica , Reto , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento , Ultrassonografia , Bexiga Urinária , Neoplasias do Colo do Útero/patologiaRESUMO
PURPOSE: To evaluate the cumulative dose at point A for three and four centimeters central shielding. MATERIAL AND METHODS: The plans of external beam radiotherapy plus conventional intracavitary brachytherapy were performed. Three or four centimeters central shieldings (after 44 Gy) were applied to the standard whole pelvis irradiation. Additional intracavitary brachytherapy 4 × 7 Gy at point A was prescribed, and the cumulative dose in EQD2 (α/ß = 10) of 3 cm and 4 cm central shielding were evaluated. RESULTS: The cumulative dose at point A in EQD2 (α/ß = 10) of 3 cm central shielding were 95.7 Gy for AR and 95.5 Gy for AL, while the cumulative dose at point As in EQD2 (α/ß = 10) of 4 cm central shielding were 90.8 Gy for AR and 91.2 Gy for AL. CONCLUSIONS: The 3 cm central shielding caused higher cumulative dose (in terms of EQD2 [α/ß = 10]) than 4 cm central shielding.