Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy

Tadashi Takenaka; Hideya Yamazaki; Gen Suzuki; Koji Masui; Daisuke Shimizu; Tadayuki Kotsuma; Eiichi Tanaka; Ken Yoshida; Kei Yamada

doi:10.5114/jcb.2023.128895

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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3/2023
vol. 15

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abstract:

Original paper

Initial tumor volume as an important predictor for indication of intra-cavitary brachytherapy, intra-cavitary/interstitial brachytherapy, and multi-catheter sole interstitial brachytherapy in cervical cancer patients treated with chemoradiotherapy

Tadashi Takenaka

¹

,

Hideya Yamazaki

¹

,

Gen Suzuki

¹

,

Koji Masui

¹

,

Daisuke Shimizu

¹

,

Tadayuki Kotsuma

²

,

Eiichi Tanaka

³

,

Ken Yoshida

⁴

,

Kei Yamada

¹

Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
Department of Radiation Oncology, Osaka Rosai Hospital, Osaka, Japan
Department of Radiology, National Hospital Organization Osaka National Hospital, Osaka, Japan
Department of Radiology, Kansai Medical College, Osaka, Japan

J Contemp Brachytherapy 2023; 15, 3: 191–197

DOI: https://doi.org/10.5114/jcb.2023.128895

Online publish date: 2023/06/23

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AMA

Takenaka T, Yamazaki H, Suzuki G, et al. Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy. Journal of Contemporary Brachytherapy. 2023;15(3):191-197. doi:10.5114/jcb.2023.128895.

APA

Takenaka, T., Yamazaki, H., Suzuki, G., Masui, K., Shimizu, D.,  & Kotsuma, T. et al. (2023). Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy. Journal of Contemporary Brachytherapy, 15(3), 191-197. https://doi.org/10.5114/jcb.2023.128895

Chicago

Takenaka, Tadashi, Hideya Yamazaki, Gen Suzuki, Koji Masui, Daisuke Shimizu, Tadayuki Kotsuma,  and Eiichi Tanaka et al. 2023. "Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy". Journal of Contemporary Brachytherapy 15 (3): 191-197. doi:10.5114/jcb.2023.128895.

Harvard

Takenaka, T., Yamazaki, H., Suzuki, G., Masui, K., Shimizu, D., Kotsuma, T., Tanaka, E., Yoshida, K.,  and Yamada, K. (2023). Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy. Journal of Contemporary Brachytherapy, 15(3), pp.191-197. https://doi.org/10.5114/jcb.2023.128895

MLA

Takenaka, Tadashi et al. "Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy." Journal of Contemporary Brachytherapy, vol. 15, no. 3, 2023, pp. 191-197. doi:10.5114/jcb.2023.128895.

Vancouver

Takenaka T, Yamazaki H, Suzuki G, Masui K, Shimizu D, Kotsuma T et al. Initial tumor volume as an important predictor 
for indication of intra-cavitary brachytherapy, 
intra-cavitary/interstitial brachytherapy, 
and multi-catheter sole interstitial brachytherapy 
in cervical cancer patients treated 
with chemoradiotherapy. Journal of Contemporary Brachytherapy. 2023;15(3):191-197. doi:10.5114/jcb.2023.128895.

Purpose:
Advances in three-dimensional image-guided brachytherapy technique allow for using intra-cavitary, intra-cavitary and interstitial brachytherapy (ICIS-BT), and sole interstitial brachytherapy (ISBT) in addition to conventional intra-cavitary brachytherapy (ICBT). However, no consensus has been reached regarding the choice of these techniques. The aim of this study was to propose the size criteria for indication of interstitial techniques.

Material and methods:
We examined initial gross tumor volume (GTV) at presentation and at each brachytherapy session. Also, dose volume histogram parameters for each modality were compared in 112 patients with cervical cancer treated with brachytherapy (ICBT, 54; ICIS-BT, 11; and ISBT, 47).

Results:
The average GTV at diagnosis was 80.9 cm3 (range, 4.4-343.2 cm³), which shrank to 20.6 cm³ (25.5% of initial volume, range, 0.0-124.8 cm³) at initial brachytherapy. GTV > 30 cm³ at brachytherapy and high-risk clinical target volume > 40 cm³ were good threshold values for indication of interstitial technique, and tumors with initial GTV > 150 cm³ could be candidates for ISBT. An ISBT dose of 89.10 Gy can be prescribed in equivalent dose in 2 Gy fractions (range, 65.5-107.6 Gy), which was higher than those of ICIS (73.94 Gy, range, 71.44-82.50 Gy) and ICBT (72.83 Gy, range, 62.50-82.27 Gy) (p < 0.0001).

Conclusions:
Initial tumor volume is an important predictor for indication of ICBT and ICIS-BT. ISBT or at least an interstitial technique is recommended for initial GTV > 150 cm³.

keywords:

Initial tumor volume as an important predictor for indication of intra-cavitary brachytherapy, intra-cavitary/interstitial brachytherapy, and multi-catheter sole interstitial brachytherapy in cervical cancer patients treated with chemoradiotherapy

Tadashi Takenaka 1 , Hideya Yamazaki 1 , Gen Suzuki 1 , Koji Masui 1 , Daisuke Shimizu 1 , Tadayuki Kotsuma 2 , Eiichi Tanaka 3 , Ken Yoshida 4 , Kei Yamada 1

cervical cancer, brachytherapy, chemoradiotherapy, ISBT, ICBT, ICIS-BT, HDR-RALS

Tadashi Takenaka

¹

,

Hideya Yamazaki

¹

,

Gen Suzuki

¹

,

Koji Masui

¹

,

Daisuke Shimizu

¹

,

Tadayuki Kotsuma

²

,

Eiichi Tanaka

³

,

Ken Yoshida

⁴

,

Kei Yamada

¹