■使用钴-60同位素的高剂量率(HDR)图像引导的近距离放射治疗是一种相对较新的方法。该研究的目的是评估肿瘤反应方面的临床和剂量学参数,膀胱,以及接受Co-60HDR近距离放射治疗的患者的直肠毒性。
■所有患者最初在我们中心或其他转诊中心接受了放化疗(CT-RT),并接受了外部束放射治疗(EBRT),剂量为45Gy-60Gy,剂量为1.8-2Gy/分数(包括淋巴结增强),同时进行顺铂或卡铂化疗。然后在完成CT-RT后1周内安排患者进行近距离放射治疗,并通过局部检查进行评估。根据近距离放射治疗时的局部检查参数,他们有资格进行腔内近距离放射治疗(ICBT)或间质近距离放射治疗(ISBT)。
■在第一阶段观察到的完全反应(CR),II,III,IVA为60%,79.4%,分别为86%和76.2%。在I期平均EQD2为78.67Gy10,83.33Gy10,84.23Gy10,85.63Gy10的患者中观察到完全反应,II,III,分别为IVA。79.2%的顺铂治疗的患者和87.5%的卡铂治疗的患者完全缓解,表明接受两种化疗的患者的缓解率相似。
■根据从研究中获得的结果,我们得出的结论是,在总体治疗时间(OTT)较短的患者中,对宫颈癌治疗的完全反应率较高。确定的CT-RT结束与近距离放射治疗和鳞状细胞组织学开始之间的间隔较短。该研究还注意到随着实现完全反应的阶段增加,平均EQD2增加到肿瘤的趋势。分别在70-90Gy3和70Gy3的EQD2患者中观察到较高的急性膀胱和直肠毒性。研究结果表明,临床结果和毒性在临床上与其他基于放射性同位素的HDR近距离放射治疗治疗相当。
UNASSIGNED: High dose rate (HDR) image-guided brachytherapy with Cobalt-60 isotope is a relatively recent approach. The aim of the study is to evaluate the clinical and dosimetric parameters in terms of tumour response, bladder, and rectal toxicity in patients undergoing Co-60 HDR brachytherapy.
UNASSIGNED: All patients were initially treated with chemoradiation (CT-RT) at our center or other referral centers with external beam radiation therapy (EBRT) for a dose of 45 Gy-60 Gy at 1.8-2Gy/fraction (including nodal boost) with concomitant chemotherapy with either cisplatin or carboplatin. Patients were then scheduled for brachytherapy within 1 week after completion of CT-RT and are assessed by local examination. Depending on local examination parameters at the time of brachytherapy they were eligible either for intracavitary brachytherapy (ICBT) or interstitial brachytherapy (ISBT).
UNASSIGNED: The complete response (CR) observed in stage I, II, III, IVA were 60%, 79.4%, 86% and 76.2% respectively. Complete response was seen in patients with mean EQD2 of 78.67 Gy10, 83.33 Gy10, 84.23 Gy10, 85.63 Gy10 in stages I, II, III, IVA respectively. 79.2% of cisplatin-treated patients and 87.5% of carboplatin-treated patients had a complete response indicating that patients treated with either chemotherapy had similar response rates.
UNASSIGNED: According to results obtained from the study we conclude by saying that higher rates of complete response to treatment in cervical cancer is seen in patients with shorter overall treatment time (OTT), shorter interval between end of definitive CT-RT and beginning of brachytherapy and squamous cell histology. The study also noted the trend of increasing mean EQD2 to tumor with increasing stage for achieving complete response. Higher acute bladder and rectal toxicity is seen in patients who received EQD2 of ¿70-90Gy3 and ¿70Gy3 respectively. The study findings suggest that the clinical outcomes and the toxicities are clinically comparable with other radioisotope based HDR brachytherapy treatment.