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  • [Radiat Oncol.] Stereotactic ablative body radiotherapy boost for cervical cancer when brachytherapy boost is not feasible

    분당서울대병원 / 이태훈, 엄근용*

  • 출처
    Radiat Oncol.
  • 등재일
    2021 Aug 12
  • 저널이슈번호
    16(1):148. doi: 10.1186/s13014-021-01877-4.
  • 내용

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    Abstract
    Background: The purpose of this study was to analyze the treatment efficacy and safety of stereotactic ablative body radiotherapy (SABR) boost for cervical cancer patients not amenable to brachytherapy.

    Methods: A retrospective review of the medical records from single institution of 25 eligible patients was performed. The patients underwent pelvic radiotherapy (RT) in 25 or 28 fractions with a median dose of 45 Gy (range 44-50.4 Gy). SABR boost was delivered after pelvic RT, with a median dose of 25 Gy (range 20-33 Gy), and a median fraction number of 5 (range 4-6). 21 patients with a follow-up period of more than one year were included in the toxicity analysis, and hematuria and hematochezia that occurred later than 3 months after the RT were graded.

    Results: The median follow-up period after radiotherapy was 2.85 years (range 0.33-6.60). The 3-year local control, locoregional control, disease-free survival, and overall survival rates were 80.9%, 75.8%, 40.9%, and 77.1%, respectively. 5 patients experienced grade 3 toxicity (3 genitourinary, 3 gastrointestinal), and no grade 4-5 toxicity was reported. Univariate analysis showed that cumulative D2cc in equivalent dose in 2 Gy fractions (EQD2) of rectum was marginally predictive for any grade of hematochezia (P = 0.051). Cumulative D2cc EQD2 of bladder was not predictive for hematuria. In the receiver operating characteristic (ROC) curve analysis, the optimal threshold of cumulative rectal D2cc EQD2 was 81.2 Gy for any grade of hematochezia.

    Conclusion: SABR boost for cervical cancer was effective and tolerable. Although it cannot substitute brachytherapy, it can be a treatment option when brachytherapy is not possible.

     

     

    Affiliations

    Tae Hoon Lee  1 , Changhoon Song  2 , In Ah Kim  2 , Jae-Sung Kim  2 , Yong Beom Kim  3 , Kidong Kim  3 , Jae Hong No  3 , Dong Hoon Suh  3 , Jin-Beom Chung  2 , Keun-Yong Eom  4
    1 Department of Radiation Oncology, Seoul National University Hospital, Seoul, Republic of Korea.
    2 Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea.
    3 Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
    4 Department of Radiation Oncology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 beon-gil, Bundang-gu, Seongnam, 13620, Republic of Korea. 978sarang@hanmail.net.

  • 키워드
    Cervical cancer; Hematochezia; Hematuria; Stereotactic body radiotherapy.
  • 편집위원

    Brachytherapy가 갖추어지지 않은 병원들이 많은 현실에서 타병원으로 전원이 어려운 경우 대체방법으로 SBRT를 시행할 수 있는데, 적은수이지만 23.8%에서 Gr3 부작용이 발생하였다는 결과를 참고하여 주의깊게 적용하여야 하겠습니다.

    2021-10-05 15:42:11

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