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Vaginal dose of radical radiotherapy for cervical cancer in China: a multicenter study.

ABSTRACT: BACKGROUND:The posterior-inferior border of symphysis (PIBS) point system is a novel vaginal dose-reporting method and is a simple and reliable method proposed by the Medical University of Vienna proposed for both external-beam radiotherapy (EBRT) and brachytherapy (BT). In this multicenter study, we sought to first evaluate the vaginal radiation dose in Chinese cervical cancer patients according to the PIBS point system and then to analyze the factors influencing the dose distribution. METHODS:We collected data from the medical records of 936 cervical cancer patients who underwent concurrent radiochemotherapy at 13 different institutions in China. Radiation doses at points A, PIBS+?2?cm, PIBS and PIBS-2?cm, International Commission on Radiation Units (ICRU)-R and ICRU-B were measured. RESULTS:The median total doses in EQD2?/??=?3 at points PIBS+?2?cm, PIBS and PIBS-2?cm were 82.5 (52.7-392.1) Gy, 56.2 (51.4-82.1) Gy and 2.6 (0.9-7.4) Gy, respectively. The median total doses in EQD2?/??=?3 at ICRU-R and ICRU-B were 77.5 (54.8-132.4) Gy and 79.9 (60.7-133.7) Gy, respectively. The mean vaginal reference length (VRL) was 4.6?±?1.0?cm (median, 4.5?cm). In patients with VRL ?4.5?cm, the mean total doses in EQD2?/??=?3 at points PIBS+?2?cm, PIBS and PIBS-2?cm were 128.5, 60.7 and 0.8?Gy, respectively. In patients with VRL >?4.5?cm, the mean total doses at these three points were 68.9, 0.5 and 54.5?Gy, respectively. Classification of patients revealed significant differences (P?

SUBMITTER: Wang J

PROVIDER: S-EPMC6915922 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Vaginal dose of radical radiotherapy for cervical cancer in China: a multicenter study.

Wang Juan J Zhang Kai-Shuo KS Wang Tao T Liu Zi Z Wang Rui-Hua RH Zhang Fu-Quan FQ Yu Lang L Ran Li L He Jian-Li JL Wang Ya-Li YL Wei Li-Chun LC Shi Mei M Wang Guo-Qing GQ Wu Chao-Qun CQ Kang Qi-Jun QJ Yang Jie J Li Sha S Yang Fei-Yue FY Liu Bao-Gang BG Liu Juan-Yue JY Shi Fan F Su Jin J Yuan Wei W Drokow Emmanuel Kwateng EK

BMC cancer 20191216 1

<h4>Background</h4>The posterior-inferior border of symphysis (PIBS) point system is a novel vaginal dose-reporting method and is a simple and reliable method proposed by the Medical University of Vienna proposed for both external-beam radiotherapy (EBRT) and brachytherapy (BT). In this multicenter study, we sought to first evaluate the vaginal radiation dose in Chinese cervical cancer patients according to the PIBS point system and then to analyze the factors influencing the dose distribution.< ...[more]

PMID: 31842811

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Project description:BackgroundTo investigate the survival outcomes of abdominal radical hysterectomy (ARH), laparoscopic radical hysterectomy (LRH), and vaginal-assisted laparoscopic radical hysterectomy (VALRH) in the treatment of cervical cancer patients.MethodsThis was a retrospective study. We collected the clinical data of 654 patients with cervical cancer (406 ARH, 172 LRH, and 76 VALRH), then compared the effects of different surgical methods on recurrence and survival.ResultsTotal overall survival (OS) were no significant differences in three groups (P>0.05). Total disease-free survival (DFS) was significantly higher in ARH group than in LRH group [hazard ratio (HR) =2.8, 95% confidence interval (CI): 1.199-3.607, P=0.004]; however, there were no significant differences between the VALRH (94.7%) and ARH (93.3%) groups. Subgroup stratification analysis showed that the overall recurrence rate in LRH group was significantly higher than that of the ARH groups for patients with a tumor size from ≥2 to <4 cm, negative postoperative lymph nodes, and no postoperative adjuvant therapy (all P<0.05). However, in the subgroup with tumor sizes of ≥2, <4, and ≥4 cm, no matter whether the lymph nodes were positive or not, and those with no postoperative supplementary adjuvant therapy, LRH was associated with a significantly higher local pelvic recurrence rate than ARH (all P<0.05). No significant differences between VALRH and ARH in any of the subgroup analyses (all P>0.05). A Cox analysis indicated that LRH increased the risk of overall and local pelvic recurrence after surgery compared with ARH (HR =2.338, 95% CI: 1.186-4.661, P=0.014; HR =10.313, 95% CI: 2.839-37.460, P<0.001); however, no significant difference between VALRH and ARH (all P>0.05). Sensitivity analysis of surgeons did not change the conclusions.ConclusionsOur analyses showed that the local pelvic recurrence rates and overall recurrence rates of LRH were significantly higher than ARH. VALRH could avoid tumor intraperitoneal exposure and achieve the same tumor prognosis as open surgery. By improving the standardization of minimally invasive surgery for early cervical cancer and paying close attention to the tumor-free concept, minimally invasive radical hysterectomy may achieve the same tumor outcome as open surgery.

Dataset Information

Vaginal dose of radical radiotherapy for cervical cancer in China: a multicenter study.

Publications

Vaginal dose of radical radiotherapy for cervical cancer in China: a multicenter study.

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