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Rabinovich A, Bernard L, Ramanakumar AV, et al. Para-aortic and pelvic extended-field radiotherapy for advanced-stage uterine cancer: dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques. Curr Oncol. 2015;22(6):405-11doi: 10.3747/co.22.2727.
Rabinovich, A., Bernard, L., Ramanakumar, A. V., Stroian, G., Gotlieb, W. H., Lau, S., & Bahoric, B. (2015). Para-aortic and pelvic extended-field radiotherapy for advanced-stage uterine cancer: dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques. Current oncology (Toronto, Ont.), 22(6), 405-11. https://doi.org/10.3747/co.22.2727
Rabinovich, A, et al. "Para-aortic and pelvic extended-field radiotherapy for advanced-stage uterine cancer: dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques." Current oncology (Toronto, Ont.) vol. 22,6 (2015): 405-11. doi: https://doi.org/10.3747/co.22.2727
Rabinovich A, Bernard L, Ramanakumar AV, Stroian G, Gotlieb WH, Lau S, Bahoric B. Para-aortic and pelvic extended-field radiotherapy for advanced-stage uterine cancer: dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques. Curr Oncol. 2015 Dec;22(6):405-11. doi: 10.3747/co.22.2727. PMID: 26715873; PMCID: PMC4687661.
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Curr Oncol. 2015 Dec;22(6):405-11. doi: 10.3747/co.22.2727.

Para-aortic and pelvic extended-field radiotherapy for advanced-stage uterine cancer: dosimetric and toxicity comparison between the four-field box and intensity-modulated techniques.

Current oncology (Toronto, Ont.)

A Rabinovich, L Bernard, A V Ramanakumar, G Stroian, W H Gotlieb, S Lau, B Bahoric

Affiliations

  1. Division of Gynecologic Oncology, Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC;
  2. Division of Radiation Oncology, Segal Cancer Centre, Jewish General Hospital, McGill University, Montreal, QC;
  3. Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal, QC.

PMID: 26715873 PMCID: PMC4687661 DOI: 10.3747/co.22.2727

Abstract

BACKGROUND: In patients with advanced-stage endometrial carcinoma (eca), extended-field radiotherapy (efrt) is traditionally delivered by the 3-dimensional conformal (3d-crt) 4-field box technique. In recent years, the use of intensity-modulated radiotherapy (imrt) in gynecologic cancers has increased. We compared the delivery of efrt by the 3d-crt and contemporary imrt techniques.

METHODS: After surgical staging and adjuvant chemotherapy in 38 eca patients, efrt was delivered by either imrt or 3d-crt. Doses to the organs at risk, side effects, and outcomes were compared between the techniques.

RESULTS: Of the 38 eca patients, 33 were stage iiic, and 5 were stage ivb. In the imrt group, maximal doses to rectum, small intestine, and bladder were significantly higher, and mean dose to bladder was lower (p < 0.0001). Most acute gastrointestinal, genitourinary, and hematologic side effects were grade i or ii and were comparable between the groups. In long-term follow-up, only grade 1 cystitis at 3 months was statistically higher in the imrt patients. No grade iii or iv gastrointestinal or genitourinary toxicities were observed. No statistically significant differences in overall and disease-free survival or recurrence rates were observed between the techniques.

CONCLUSIONS: In advanced eca patients, imrt is a safe and effective technique for delivering efrt to the pelvis and para-aortic region, and it is comparable to the 3d-crt 4-field box technique in both side effects and efficacy. For centres in which imrt is not readily available, 3d-crt is a valid alternative.

Keywords: 3-dimensional conformal 4-field box technique; Extended-field radiotherapy; intensity-modulated radiotherapy

References

  1. Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):428-34 - PubMed
  2. Int J Radiat Oncol Biol Phys. 2008 Aug 1;71(5):1343-50 - PubMed
  3. Int J Radiat Oncol Biol Phys. 2003 May 1;56(1):83-8 - PubMed
  4. Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):539-45 - PubMed
  5. Int J Radiat Oncol Biol Phys. 2002 Apr 1;52(5):1330-7 - PubMed
  6. Gynecol Oncol. 2013 Mar;128(3):535-9 - PubMed
  7. Gynecol Oncol. 2006 Aug;102(2):195-9 - PubMed
  8. Gynecol Oncol. 2013 Dec;131(3):574-80 - PubMed
  9. Int J Radiat Oncol Biol Phys. 2003 Aug 1;56(5):1354-60 - PubMed
  10. Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):1170-6 - PubMed
  11. Int J Radiat Oncol Biol Phys. 2012 Sep 1;84(1):e23-8 - PubMed
  12. Gynecol Oncol. 2014 Jan;132(1):38-43 - PubMed
  13. Radiat Oncol. 2012 Nov 23;7:197 - PubMed
  14. Gynecol Oncol. 2013 Jan;128(1):65-70 - PubMed
  15. Int J Radiat Oncol Biol Phys. 2014 Feb 1;88(2):357-62 - PubMed
  16. Pract Radiat Oncol. 2013 Jan-Mar;3(1):e21-8 - PubMed
  17. Int J Radiat Oncol Biol Phys. 1991 May 15;21(1):109-22 - PubMed
  18. Clin Oncol (R Coll Radiol). 2012 Sep;24(7):499-507 - PubMed
  19. Radiother Oncol. 2014 Apr;111(1):138-43 - PubMed
  20. J Formos Med Assoc. 2014 Dec;113(12):949-55 - PubMed
  21. Gynecol Oncol. 2013 Jul;130(1):229-36 - PubMed
  22. Gynecol Oncol. 2013 Jun;129(3):478-85 - PubMed
  23. Cancer. 2005 Sep 15;104(6):1296-303 - PubMed
  24. Radiat Med. 2007 Nov;25(9):439-45 - PubMed
  25. Obstet Gynecol Clin North Am. 2001 Dec;28(4):743-57 - PubMed
  26. Int J Gynecol Cancer. 2010 Aug;20(6):1000-5 - PubMed
  27. Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):935-43 - PubMed

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