Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy

Hsieh Chen-Hsi, Wei Ming-Chow, Lee Hsing-Yi, Hsiao Sheng-Mou, Chen Chien-An, Wang Li-Ying, Hsieh Yen-Ping, Tsai Tung-Hu, Chen Yu-Jen, Shueng, Shueng Pei-Wei

Description

To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer. Methods Between November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with cisplatin, 40 mg/m 2 intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0). Results The mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease-free survival, locoregional control and distant metastasis-free rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully. Conclusion HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long-term follow-up and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted.

Informations

• Publié par: biomed
• Publié le: 01 janvier 2009
• Nombre de lectures: 4
• Langue: English

Extrait

Radiation Oncology

BioMedCentral

Open Access Research Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy 1,3 2 1 2 ChenHsi Hsieh , MingChow Wei , HsingYi Lee , ShengMou Hsiao , 1 7 8 3,9 ChienAn Chen , LiYing Wang , YenPing Hsieh , TungHu Tsai , 3,4,5,6 1,10,11 YuJen Chen* and PeiWei Shueng*

1 2 Address: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan, Departments of Obstetrics and Gynecology, Far 3 Eastern Memorial Hospital, Taipei, Taiwan, Institute of Traditional Medicine, School of Medicine, National YangMing University, Taipei, Taiwan, 4 5 Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan, Department of Medical Research, Mackay Memorial Hospital, 6 7 Taipei, Taiwan, Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan, School and Graduate Institute of 8 Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan, Department of Healthcare Administration, Asia University, 9 10 Taichung, Taiwan, Department of Education and Research, Taipei City Hospital, Taipei, Taiwan, Department of Radiation Oncology, National 11 Defense Medical Center, Taipei, Taiwan and General Education Center, Oriental Technology Institute, Taipei, Taiwan

Email: ChenHsi Hsieh  [e-mail]; MingChow Wei  [e-mail]; HsingYi Lee  [e-mail]; ShengMou Hsiao  [e-mail]; ChienAn Chen  [e-mail]; LiYing Wang  [e-mail]; Yen Ping Hsieh  [e-mail]; TungHu Tsai  [e-mail]; YuJen Chen*  [e-mail]; Pei Wei Shueng*  [e-mail] * Corresponding authors

Published: 10 December 2009 Received: 22 September 2009 Accepted: 10 December 2009 Radiation Oncology2009,4:62 doi:10.1186/1748717X462 This article is available from: http://www.rojournal.com/content/4/1/62 © 2009 Hsieh et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract Background:To review the experience and to evaluate the treatment plan of using helical tomotherapy (HT) for the treatment of cervical cancer.

Methods:Between November 1st, 2006 and May 31, 2009, 10 cervical cancer patients histologically confirmed were enrolled. All of the patients received definitive concurrent chemoradiation (CCRT) with whole pelvic HT (WPHT) followed by brachytherapy. During WPHT, all patients were treated with 2 cisplatin, 40 mg/m intravenously weekly. Toxicity of treatment was scored according to the Common Terminology Criteria for Adverse Events v3.0 (CTCAE v3.0).

Results:The mean survival was 25 months (range, 3 to 27 months). The actuarial overall survival, disease free survival, locoregional control and distant metastasisfree rates at 2 years were 67%, 77%, 90% and 88%, respectively. The average of uniformity index and conformal index was 1.06 and 1.19, respectively. One grade 3 of acute toxicity for diarrhea, thrombocytopenia and three grade 3 leucopenia were noted during CCRT. Only one grade 3 of subacute toxicity for thrombocytopenia was noted. There were no grade 3 or 4 subacute toxicities of anemia, leucopenia, genitourinary or gastrointestinal effects. Compared with conventional whole pelvic radiation therapy (WPRT), WPHT decreases the mean dose to rectum, bladder and intestines successfully.

Conclusion:HT provides feasible clinical outcomes in locally advanced cervical cancer patients. Long term followup and enroll more locally advanced cervical carcinoma patients by limiting bone marrow radiation dose with WPHT technique is warranted.

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