Evaluation of the rectal V30 parameter in patients diagnosed with postoperative endometrial cancer
Abstract
Background: The present paper reports on analysis of 184 patients who were diagnosed with endometrial cancer. The main objective of this study was to address parameter Vrec(30Gy) which determines a volume of the rectum irradiated with a dose of 30 Gy during radiotherapy.
Materials and methods: All patients were irradiated with an IMRT technique on linear accelerators. The planning target volume (PTV) contour was determined by a radiation oncologist. The clinical target volume (CTV) was drawn on CT images obtained in a prone position. For statistical analysis, appropriate tests (e.g. the Shapiro-Wilk, Wilcoxon) were used.
Results and discussion: The performed analysis showed that the recommended condition for Vrec(30Gy) is met only in 3% of patients and the observed median value exceeds 90%. The obtained results were compared with the studies in which the Vrec(30Gy) values were related to various radiotherapy techniques.
Conclusions: The analysis showed that the condition for Vrec(30Gy) is satisfied in the case of only 3% of patients. Due to the difficulty with meeting the condition, it should be reconsidered based on real results.
Keywords: radiotherapymedical physicsradiation oncologyendometrial neoplasmsrectum
References
- Malicki J, Slosarek K. Planowanie leczenia i dozymetria w radioterapii. Via Medica, Gdańsk 2016.
- Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6): 394–424.
- Miller KD, Nogueira L, Mariotto AB, et al. Cancer treatment and survivor-ship statistics. CA Cancer J Clin. 2019; 69(5): 363–385.
- Andreyev HJN. Gastrointestinal problems after pelvic radiotherapy: the past, the present and the future. Clin Oncol (R Coll Radiol). 2007; 19(10): 790–799.
- Mitra D, Nout R, Catalano PJ, et al. Rectal bleeding after radiation therapy for endometrial cancer. Radiother Oncol. 2015; 115(2): 240–245.
- Kuku S, Fragkos C, McCormack M, et al. Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers. Br J Cancer. 2013; 109(6): 1504–1512.
- McKinney W. Python for Data Analysis: Data Wrangling with Pandas, NumPy, and IPython. 2 ed . O’Reilly Media, Farnham 2017.
- Bruce P, Bruce A. Practical Statistics for Data Scientists. 50 Essential Concepts. 1st editon. O’Reilly Media, Farnham 2017: 1491952962.
- Jhingran A, Winter K, Portelance L, et al. A phase II study of intensity modulated radiation therapy to the pelvis for postoperative patients with endometrial carcinoma: radiation therapy oncology group trial 0418. Int J Radiat Oncol Biol Phys. 2012; 84(1): e23–e28.
- Wu CC, Wuu YR, Yanagihara T, et al. Rectal balloon use limits vaginal displacement, rectal dose, and rectal toxicity in patients receiving IMRT for postoperative gynecological malignancies. Med Dosim. 2018; 43(1): 23–29.
- Hsieh CH, Wei MC, Lee HY, et al. Whole pelvic helical tomotherapy for locally advanced cervical cancer: technical implementation of IMRT with helical tomothearapy. Radiat Oncol. 2009; 4(1).
- Georg P, Georg D, Hillbrand M, et al. Factors influencing bowel sparing in intensity modulated whole pelvic radiotherapy for gynaecological malignancies. Radiother Oncol. 2006; 80(1): 19–26.
- Menkarios C, Azria D, Laliberté B, et al. Optimal organ-sparing intensity-modulated radiation therapy (IMRT) regimen for the treatment of locally advanced anal canal carcinoma: a comparison of conventional and IMRT plans. Radiat Oncol. 2007; 2(1).
- Mell L, Tiryaki H, Ahn KH, et al. Dosimetric Comparison of Bone Marrow-Sparing Intensity-Modulated Radiotherapy Versus Conventional Techniques for Treatment of Cervical Cancer. Int J Radiat Oncol Biol Phys. 2008; 71(5): 1504–1510.
- Roeske J, Lujan A, Rotmensch J, et al. Intensity-modulated whole pelvic radiation therapy in patients with gynecologic malignancies. Int J Radiat Oncol Biol Phys. 2000; 48(5): 1613–1621.
- Yavas G, Yavas C, Acar H, et al. Dosimetric comparison of 3-dimensional conformal and field-in-field radiotherapy techniques for the adjuvant treatment of early stage endometrial cancer. Phys Med. 2013; 29(6): 577–582.
- Panda S, Swamidas J, Chopra S, et al. Treatment planning comparison of volumetric modulated arc therapy employing a dual-layer stacked multi-leaf collimator and helical tomotherapy for cervix uteri. Radiat Oncol. 2020; 15(1).
- Lim TY, Dragojević I, Hoffman D, et al. Characterization of the Halcyon multileaf collimator system. J Appl Clin Med Phys. 2019; 20(4): 106–114.