Dosimetric research into target regions and organs at risk in three-dimensional intracavitary brachytherapy techniques for Chinese patients with cervical carcinoma.

Abstract

The present study aimed to compare the dosages of target regions and organs at risk (OARs) in 3D intracavitary brachytherapy (ICBT) and conventional 2D ICBT for Chinese patients with cervical carcinoma. ICBT was performed in a total of 66 patients with Stage IB to IVA cervical carcinoma who had not received surgery but who had received whole-pelvic external-beam radiotherapy (EBRT). Plans for the 3D-ICBT and the conventional 2D-ICBT were individually designed for every patient. The dosages differences between the target regions and the OARs in patients with each of the various stages of cervical carcinoma were compared between the two ICBT plans. There was no significant difference in the dose at Point A between the two ICBT plans. However, the CTVhr-D90, CTVhr-D100 and CTVir-D90 in 3D-ICBT were much higher than in 2D-ICBT, especially in Stage IIB (P < 0.05). As compared with conventional 2D-ICBT, the dosages of DICRU and D2.0cm3 in the rectum/bladder, and D2.0cm3 in the sigmoid/small bowel were decreased significantly in 3D-ICBT (P < 0.05). For patients with Stage IIA, IIB and IIIB, the D2.0cm3 in the rectum/bladder was significantly reduced in 3D-ICBT (P < 0.05). It was demonstrated that, in Chinese patients, 3D-ICBT for cervical carcinoma could optimize the target coverage and reduce the dosages to the OARs compared with conventional 2D-ICBT.