Acute toxicities of three-dimensional conformal radiotherapy in the treatment of gynecological cancer, and retrospective dosimetric comparison of three dimensional conformal radiotherapy and invers intensity-modulated radiotherapy

摘要

Ama?: Jinekolojik kanserlerde retrospektif ü? boyutlu konformal radyoterapi tedavisine ait akut yan etkileri de?erlendirmek ve yo?unluk ayarl? radyoterapinin ve ü? boyutlu konformal radyoterapinin kemik ili?i ve riskli organlar?n dozimetrik olarak kar??la?t?rmak ama?lanm??t?r. Y?ntemler: ü? boyutlu konformal radyoterapi ile tedavisi tamamlanm?? 28 hasta retrospektif olarak de?erlendirildi ve hastalar IMRT tekni?ine g?re yeniden planland?. Olgular?n kemik ili?i ve kritik organ dozlar? dozimetrik olarak kar??la?t?r?ld?. Olgularda yan etki de?erlendirmesi RTOG toksisite skalas? ve ya?am kalitesi Avrupa Kanser Ara?t?rma ve Tedavi Merkezi (EORTC) QLQ30 anketi uygulanarak de?erlendirildi. Bulgular: Akut yan etkiler de?erlendirildi?inde grad 1 alt gastrointestinal (GIS) yan etki 16 (% 57,1) olguda, grad 1 üst GIS yan etki 9 (%32,1) olguda, grad 1 hematolojik yan etki 1 (% 3,6) olguda, grad 1 cilt yan etki 14 (% 50) olguda g?rüldü. Grad 2 üst GIS yan etki 1 (% 3,6) olguda, grad 2-3 hematolojik yan etki 11 (% 39,3) olguda g?rüldü. Kemik ili?i V20 (p0,001), kemik ili?i V95 (%) (p0,001) mesane V40 (p0,001), mesane ortalama doz (p0,001), rektum V40 (p0,001), rektum ortalama doz (p0,001), ince barsak V40 (p0,001) yo?unluk ayarl? radyoterapi ile konformal radyoterapiden daha dü?ük doz ald?. Sonu?: IMRT reduce dose to the bone marrow and the normal tissues as compared to 3D-CRT. ü? boyutlu radyoterapi jinekolojik kanserlerde dü?ük yan etki seviyesiyle kabul edilebilir güvenilir bir tedavidir ve ya?am kalitesini olumsuz etkilemez. Yo?unluk ayarl? radyoterapi kemik ili?i ve riskli organ dozlar?n? konformal radyoterapiye g?re daha iyi k?s?tlar. Aim: The study was designed to compare the critical organ and bone marrow doses with three-dimensional conformal radiotherapy plans and intensity-modulated radiotherapy re-treatment plans and to evaluate acute toxicities of three-dimensional conformal radiotherapy for gynecological cancer. Methods: Twenty-eight patients who underwent conformal radiotherapy (3D-CRT) were evaluated retrospectively and were re- planned according to IMRT technique. The critical organ and bone marrow doses of patients were compared dosimetrically. Evaluation of early side effects was performed using RTOG toxicity scale and European Organization for Research and Treatment of Cancer (EORTC) QLQ30 side effect evaluation questionnaire. Results: The assessment of early toxicity revealed Grade 1 lower gastrointestinal (GIS) toxicity in 16 (57.1%) patients, grade 1 upper GIS toxicity in 9 (32.1%) patients, grade 1 hematological toxicity in one (3.6%) patients, grade 1 genitourinary toxicity in 15 (53.6%), grade 1 skin toxicity in (50%) 14 patients . One patient (3.6%) had grade 2 upper GIS toxicity, 11 patients (39.3%) had grade 2-3 hematological toxicity. Bone marrow V20 (p0.001), V95 (%) of bone marrow (p0.001), urinary bladder V40 (p0.001), urinary bladder mean dose (p0.001), rectum V40 (p0.001), rectum mean dose (p0.001), small bowel V40 (p0.001) were received lower doses in the IMRT planning arm than the conformal planning arm. Conclusion: 3D-CRT is a safe treatment with acceptable low toxicity levels in gynecological cancer patients, and it does not adversely affect quality of life. IMRT reduce dose to the bone marrow and the normal tissues as compared to 3D-CRT.