Dosimetric advantages and clinical outcomes of simultaneous integrated boost intensity-modulated radiotherapy for anal squamous cell carcinoma

• 발행기관: 대한방사선종양학회
• 저자명: Katsuyuki Sakanaka Satoshi Itasaka Yuichi Ishida Kota Fujii Takahiro Horimatsu Takashi Mizowaki Yoshiharu Sakai Masahiro Hiraoka
• 간행물 정보: 『대한방사선종양학회지』제35권 제4호, 368~379쪽, 전체 12쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2017.12.30

영문 초록

Purpose: The purpose of this study was to explore the dosimetric difference between simultaneous integrated boost intensitymodulated radiotherapy (SIB-IMRT) and three-dimensional conformal radiotherapy (3DCRT), and the clinical outcomes of anal squamous cell carcinoma (ASCC) chemoradiotherapy featuring SIB-IMRT. Materials and Methods: This study included ten patients with ASCC who underwent chemoradiotherapy using SIB-IMRT with 5-fluorouracil and mitomycin C. SIB-IMRT delivered 54 Gy to each primary tumor plus metastatic lymph nodes and 45 Gy to regional lymph nodes, in 30 fractions. Four patients received additional boosts to the primary tumors and metastatic lymph nodes; the median total dose was 54 Gy (range, 54 to 60 Gy). We additionally created 3DCRT plans following the Radiation Therapy Oncology Group 9811 protocol to allow dosimetric comparisons with SIB-IMRT. Locoregional control, overall survival, and toxicity were calculated for the clinical outcome evaluation. Results: Compared to 3DCRT, SIB-IMRT significantly reduced doses to the external genitalia, bladder, and intestine, delivering the doses to target and elective nodal region. At a median follow-up time of 46 months, 3-year locoregional control and overall survival rates were 88.9% and 100%, respectively. Acute toxicities were treated conservatively. All patients completed radiotherapy with brief interruptions (range, 0 to 2 days). No patient experienced ≥grade 3 late toxicity during the follow-up period. Conclusion: The dosimetric advantages of SIB-IMRT appeared to reduce the toxicity of chemoradiotherapy for ASCC achieving high locoregional control in the extended period.

목차

Abstract

Introduction

Materials and Methods

Results

Discussion and Conclusion

Conflict of Interest

Acknowledgments

References

키워드

Anus neoplasms Chemoradiotherapy Intensity-modulated radiotherapy Computer-assisted radiotherapy planning Treatment outcome