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논문 기본 정보

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학술저널
저자정보
Suman Dhabal (Department, of Radiation Oncology, Burdwan Medical College, Purba Bardhaman) Abhishek Basu (Department, of Radiation Oncology, Burdwan Medical College, Purba Bardhaman) Saikat Sau (Department, of Radiation Oncology, Cardiology, Burdwan Medical College, Purba Bardhaman) Sourav Sau (Department, of Radiation Oncology, Burdwan Medical College, Purba Bardhaman) Pradip Kumar Maiti (Department of Radiation Oncology, Agartala Government Medical College) Abhay Chakravarty (Department, of Radiation Oncology, Burdwan Medical College, Purba Bardhaman)
저널정보
대한산부인과학회 Obstetrics & Gynecology Science Obstetrics & Gynecology Science Vol.67 No.1
발행연도
2024.1
수록면
67 - 75 (9page)
DOI
10.5468/ogs.23048

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Objective To analyze tumour response and toxicity with respect to cumulative radiotherapy dose to target and organs at risk (OARs) with computed tomography (CT)-based image guided adaptive brachytherapy planning for locally advanced carcinoma cervix. Methods Patients were treated with two-dimensional concurrent chemoradiotherapy to whole pelvis followed by intracavitary brachytherapy (ICBT) with dose prescription to point ‘A’. CT image-based delineation of high-risk clinical target volume (HR-CTV), urinary bladder, rectum and sigmoid colon was done with generation of dose-volume histogram (DVH) data and optimization of doses to target and OARs. Follow up assessments were done for response of disease and toxicity with generation of data for statistical analysis. Results One hundred thirty-six patients were enrolled in the study. Delineated volume of HR-CTV ranged from 20.9 to 37.1 mL, with median value of 30.2 mL. The equivalent dose in 2 Gy per fraction (EQD2) for point ‘A’ ranged from 71.31 to 79.75 Gy with median value of 75.1 Gy and EQD2 HR-CTV D90 ranged from 71.9 to 89.7 Gy with median value of 85.1 Gy. 69.2% of patients showed complete response and after median follow-up of 25 months, 50 patients remained disease free, of whom, 74.0% had received ≥85 Gy to HR-CTV D90 versus 26.0% receiving <85 Gy to HR-CTV D90. Conclusions Amidst the unavailability of magnetic resonance imaging facilities in low middle income countries, incorporation of CT-image based treatment planning into routine practice for ICBT provides the scope to delineate volumes of target and OARs and to generate DVH data, which can prove to be a better surrogate for disease response and toxicity.

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