Clinical Outcomes of Computed Tomography-Based Volumetric Brachytherapy Planning for XXXX .

@entity1 @entity137 @entity5 @entity15855 @entity189 @entity344
PURPOSE/OBJECTIVES: A report of clinical outcomes of a computed tomography (CT)-based image guided brachytherapy (IGBT) technique for treatment of @entity5 . METHODS AND MATERIALS: Seventy-six @entity1 with International Federation of Gynecology and Obstetrics stage IB to IVA cervical @entity189 diagnosed between 2007 and 2014 were treated with definitive external beam radiation therapy (EBRT) with or without concurrent chemotherapy followed by high-dose-rate (HDR) IGBT. All @entity1 underwent planning CT simulation at each implantation. A high-risk clinical target volume ( @entity15855 ) encompassing any visible @entity5 and the entire cervix was contoured on the simulation CT. When available, magnetic resonance imaging (MRI) was performed at implantation to assist with @entity5 delineation. The prescription dose was prescribed to the @entity15855 . RESULTS: The median follow-up time was 17  months. Thirteen @entity1 (17%) had an MRI done before brachytherapy, and 16 @entity1 (21%) were treated without MRI guidance. The mean EBRT/IGBT sum 2-Gy equivalent dose (EQD2) delivered to the 90% volume of the @entity15855 was 86.3  Gy. The mean maximum EQD2s delivered to 2  cm(3) of the rectum, sigmoid, and bladder were 67.5  Gy, 66.2  Gy, and 75.3  Gy, respectively. The 2-year cumulative incidences of local, locoregional, and distant failure were 5.8% (95% confidence interval [CI]: 1.4%-14.8%), 15.1% (95% CI: 5.4%-29.4%), and 24.3% (95% CI: 12.1%-38.9%), respectively. The 2-year overall and disease-free survival rates were 75% (95% CI, 61%-91%) and 73% (95% CI, 60%-90%), respectively. Twenty-nine @entity1 (38%) experienced grade >= 2 acute @entity137 , with 5 cases of acute grade 3 @entity137 and no grade >= 4 @entity137 . One @entity1 experienced grade 3 @entity344 . No other late grade >= 3 events were observed. CONCLUSIONS: This is the largest report to date of CT/MRI-based IGBT for the treatment of @entity5 . The results are promising, with excellent local control and acceptable @entity137 . Further investigation is needed to assess the long-term safety and efficacy of this treatment.
