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Abstract：
To define the relationship between the Point A prescription dose and the dose delivered to various pelvic lymph node groups during high-dose-rate (HDR) brachytherapy treatment of cervical cancer. In less developed countries, brachytherapy is often done without three-dimensional image guidance, instead relying on plain radiography and prescription to Point A. A defined relationship between Point A dose and lymph node doses would help physicians in these health care settings to more accurately estimate nodal doses.
Treatment data from 50 fractions of HDR brachytherapy of cervical cancer were reviewed, the pelvic lymph nodes were contoured, and dose-volume histogram parameters were obtained. Dose-volume histogram parameters for each contour were normalized as a percentage of the corresponding Point A dose. All nodal groups were divided into left and right sides, except the presacral nodal group.
Mean Point A doses were bilateral (Bil) 5.92 Gy ± 0.58, left (L) 5.93 ± 0.59, and right (R) 5.92 ± 0.59. Mean normalized D90 values for the various lymph node groups were as follows-obturator: Bil 20.3% ± 4.5, L 20.5% ± 4.4, and R 20.2% ± 5.2; external iliac: Bil 9.5% ± 2.9, L 10.0% ± 3.1, and R 9.5% ± 3.0; internal iliac: Bil 12.2% ± 3.5, L 12.1% ± 3.4, and R 12.9% ± 4.7; common iliac: Bil 4.3% ± 1.6, L 4.3% ± 1.6, and R 4.3% ± 1.7; and presacral: 8.7% ± 3.4. These relationships can serve as a useful tool for evaluating lymph node doses during HDR brachytherapy of cervical cancer in facilities performing two-dimensional treatment planning and those with limited resources.
Treatment data from 50 fractions of HDR brachytherapy of cervical cancer were reviewed, the pelvic lymph nodes were contoured, and dose-volume histogram parameters were obtained. Dose-volume histogram parameters for each contour were normalized as a percentage of the corresponding Point A dose. All nodal groups were divided into left and right sides, except the presacral nodal group.
Mean Point A doses were bilateral (Bil) 5.92 Gy ± 0.58, left (L) 5.93 ± 0.59, and right (R) 5.92 ± 0.59. Mean normalized D90 values for the various lymph node groups were as follows-obturator: Bil 20.3% ± 4.5, L 20.5% ± 4.4, and R 20.2% ± 5.2; external iliac: Bil 9.5% ± 2.9, L 10.0% ± 3.1, and R 9.5% ± 3.0; internal iliac: Bil 12.2% ± 3.5, L 12.1% ± 3.4, and R 12.9% ± 4.7; common iliac: Bil 4.3% ± 1.6, L 4.3% ± 1.6, and R 4.3% ± 1.7; and presacral: 8.7% ± 3.4. These relationships can serve as a useful tool for evaluating lymph node doses during HDR brachytherapy of cervical cancer in facilities performing two-dimensional treatment planning and those with limited resources.
摘要：
定义宫颈癌高剂量率（HDR）近距离放射治疗期间，A点处方剂量与各个盆腔淋巴结组的剂量之间的关系。在欠发达国家,近距离放射治疗通常在没有三维图像引导的情况下进行，相反,我们依赖于X线平片和A点的处方。A点剂量和淋巴结剂量之间的明确关系将有助于这些医疗机构的医生更准确地估计淋巴结剂量。
回顾了50次HDR近距离放射治疗宫颈癌的治疗数据，盆腔淋巴结轮廓，并获得剂量-体积直方图参数。将每个轮廓的剂量-体积直方图参数标准化为相应的A点剂量的百分比。所有的节点组被分为左侧和右侧，除了骶前结节组。
平均A点剂量为双侧（Bil）5.92Gy±0.58，左（L）5.93±0.59和右（R）5.92±0.59。各个淋巴结组的平均归一化D90值如下：闭孔：Bil20.3％±4.5，L20.5％±4.4和R20.2％±5.2；外髂关节：Bil9.5％±2.9，L10.0％±3.1和R9.5％±3.0；内髂关节：Bil12.2％±3.5，L12.1％±3.4和R12.9％的平均D9L：1.6％±4.3％和4.7％的Bil±这些关系可以作为在执行二维治疗计划的设施和资源有限的设施中评估宫颈癌的HDR近距离放射治疗期间的淋巴结剂量的有用工具。
回顾了50次HDR近距离放射治疗宫颈癌的治疗数据，盆腔淋巴结轮廓，并获得剂量-体积直方图参数。将每个轮廓的剂量-体积直方图参数标准化为相应的A点剂量的百分比。所有的节点组被分为左侧和右侧，除了骶前结节组。
平均A点剂量为双侧（Bil）5.92Gy±0.58，左（L）5.93±0.59和右（R）5.92±0.59。各个淋巴结组的平均归一化D90值如下：闭孔：Bil20.3％±4.5，L20.5％±4.4和R20.2％±5.2；外髂关节：Bil9.5％±2.9，L10.0％±3.1和R9.5％±3.0；内髂关节：Bil12.2％±3.5，L12.1％±3.4和R12.9％的平均D9L：1.6％±4.3％和4.7％的Bil±这些关系可以作为在执行二维治疗计划的设施和资源有限的设施中评估宫颈癌的HDR近距离放射治疗期间的淋巴结剂量的有用工具。
