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Dose–effect relationship between dose–volume parameters of residual gross tumor volume and clinical prognosis in MRI-guided adaptive brachytherapy for locally advanced cervical cancer: a single-center retrospective study

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Abstract

Purpose

To investigate the dose–effect relationship between the dose–volume parameters of residual gross tumor volume (GTVres) and clinical prognosis in MRI image-guided adaptive brachytherapy (IGABT) of patients with locally advanced cervical cancer in our center.

Materials and method

The clinical data of 93 patients with locally advanced cervical squamous cell cancer who received external beam radiotherapy (EBRT) combined with IGABT ± chemotherapy in our center were retrospectively analyzed. The disease stage, overall treatment time (OTT), chemotherapy, and the dose–volume parameters D90, D98, and D100 of GTVres, the intermediate-risk clinical target volume (CTVIR), and the high-risk clinical target volume (CTVHR) of the patients were statistically analyzed. Kaplan–Meier and uni- and multivariable Cox regression analyses were used to analyze 2‑year overall survival (OS), progression-free survival (PFS), and local control rate (LC). A probit model was employed to assess the dose–effect relationship between the volume and dose–volume parameters of GTVres and 2‑year OS, PFS, and LC.

Results

The median follow-up time was 19.6 months and 2‑year OS, PFS, and LC were 79.6%, 68.8%, and 94.6%, respectively. CTVHR D90 was an independent influencing factor for 2‑year PFS (P = 0.041); GTVresBT1 volume was an independent factor for 2‑year OS, PFS, and LC (P < 0.001). The probit model showed that at GTVresBT1 volume < 32.86 cm3, the expected 2‑year LC was > 90%; at GTVres D98 > 129.12 GyEQD2, the expected 2‑year OS was > 90%.

Conclusion

Both the volume and dose–volume parameters of GTVres are promising predictors in assessment of IGABT prognosis of cervical cancer.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (grant numbers 82073331, 81201737, 31600679, 81703034, 82003208), the Project of Science and Technology Department of Jilin Province (grant numbers 20190303151SF, 20210401138YY), and the Horizontal Project of Jilin University (grant numbers 2019YX435, 2019155).

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Authors and Affiliations

  1. Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, No.126 Xiantai Street, Changchun, China

    Tianyang Ke, Jinbao Wang, Ning Zhang, Hongfu Zhao, Xin Guo, Zhipeng Zhao, Zhuang Mao & Guanghui Cheng

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  1. Tianyang Ke
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  2. Jinbao Wang
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  4. Hongfu Zhao
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  8. Guanghui Cheng
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Contributions

TK performed the statistical analysis and drafted the manuscript. GC and JW designed the study. GC performed manuscript review. NZ and XG performed patient follow-up and data collection. HZ, ZZ, and MZ devised the treatment plan. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Guanghui Cheng.

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Conflict of interest

T. Ke, J. Wang, N. Zhang, H. Zhao, X. Guo, Z. Zhao, Z. Mao, and G. Cheng declare that they have no competing interests.

Additional information

The authors Tianyang Ke and Jinbao Wang contributed equally to the manuscript.

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The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Ke, T., Wang, J., Zhang, N. et al. Dose–effect relationship between dose–volume parameters of residual gross tumor volume and clinical prognosis in MRI-guided adaptive brachytherapy for locally advanced cervical cancer: a single-center retrospective study. Strahlenther Onkol 199, 131–140 (2023). https://doi.org/10.1007/s00066-022-02000-6

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