Predictive value of linear-quadratic model in the treatment of cervical cancer using high-dose-rate brachytherapy

Brij Sood, Madhur K. Garg, Jai Avadhani, Giridhar Gorla, Harish Malhotra, Chandan Guha, Shivaji Deore, Bhadrasain Vikram

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Purpose: To determine whether a dose-response relationship exists between the biologic effective dose (BED) at Point A and the bladder and rectum and the clinical outcomes in our experience with external beam radiotherapy (EBRT) and high-dose-rate brachytherapy in the treatment of cervical carcinoma. Methods and Materials: This was a retrospective study. A total of 49 patients with cervical cancer were treated with a combination of EBRT (median 45 Gy, range 41.4-50.4) and high-dose-rate brachytherapy (median 18 Gy; range 18-19, in two fractions). Twenty-three patients received concomitant cisplatin-based chemotherapy. The cumulative BEDs were calculated at Point A (BED10) and at bladder and rectal reference points (BED3) using the linear-quadratic equation. The BED10 values, after incorporating a time factor (BED10tf) in the formula, were also calculated. Results: In patients treated with RT alone, the local failure rate was 10% (1 of 10) and 19% (3 of 16) in patients receiving a BED10 >89 Gy10 or <89 Gy10 to Point A, respectively (p = 0.2). The corresponding local failure rates were 20% (3 of 15) and 0% (0 of 8) in patients treated with concomitant chemotherapy (p = 0.3). In patients treated with RT alone, the local failure rate was 7.7% (1 of 13) and 23% (3 of 13) in patients with a BED10tf >64 Gy10 or <64 Gy10 (p = 0.1), respectively. The median BED3 values at the rectal and bladder point was 95.5 Gy3 and 103.6 Gy3, respectively. Only 1 case of Grade 2 late rectal toxicity (2%) and no late bladder toxicity occurred. Conclusion: In patients treated with RT alone, a BED10 >89 Gy and a BED10tf >64 Gy indicated a trend toward a better local control rate. This difference was not observed in patients receiving chemotherapy. A BED3 <100 Gy3 was associated with negligible late toxicity. Although the BED10 in our study was about 10-15 Gy10 less than that in the published data, the 4-year local control rate of 80% and 83% and disease-free survival rate of 75% and 70% with and without chemotherapy, respectively, compare well with the rates in other studies in the literature.

Original languageEnglish (US)
Pages (from-to)1377-1387
Number of pages11
JournalInternational Journal of Radiation Oncology Biology Physics
Volume54
Issue number5
DOIs
StatePublished - Dec 1 2002

Fingerprint

Brachytherapy
Uterine Cervical Neoplasms
Linear Models
cancer
dosage
chemotherapy
Drug Therapy
bladder
Urinary Bladder
Radiotherapy
Therapeutics
radiation therapy
quadratic equations
Rectum
Cisplatin
Disease-Free Survival
rectum
Survival Rate
Retrospective Studies
toxicity

Keywords

  • Biological equivalent dose
  • Cervical cancer
  • Linear-quadratic model
  • Radiation therapy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Predictive value of linear-quadratic model in the treatment of cervical cancer using high-dose-rate brachytherapy. / Sood, Brij; Garg, Madhur K.; Avadhani, Jai; Gorla, Giridhar; Malhotra, Harish; Guha, Chandan; Deore, Shivaji; Vikram, Bhadrasain.

In: International Journal of Radiation Oncology Biology Physics, Vol. 54, No. 5, 01.12.2002, p. 1377-1387.

Research output: Contribution to journalArticle

Sood, Brij ; Garg, Madhur K. ; Avadhani, Jai ; Gorla, Giridhar ; Malhotra, Harish ; Guha, Chandan ; Deore, Shivaji ; Vikram, Bhadrasain. / Predictive value of linear-quadratic model in the treatment of cervical cancer using high-dose-rate brachytherapy. In: International Journal of Radiation Oncology Biology Physics. 2002 ; Vol. 54, No. 5. pp. 1377-1387.
@article{f363678926bd4bd78f465757c56ce94d,
title = "Predictive value of linear-quadratic model in the treatment of cervical cancer using high-dose-rate brachytherapy",
abstract = "Purpose: To determine whether a dose-response relationship exists between the biologic effective dose (BED) at Point A and the bladder and rectum and the clinical outcomes in our experience with external beam radiotherapy (EBRT) and high-dose-rate brachytherapy in the treatment of cervical carcinoma. Methods and Materials: This was a retrospective study. A total of 49 patients with cervical cancer were treated with a combination of EBRT (median 45 Gy, range 41.4-50.4) and high-dose-rate brachytherapy (median 18 Gy; range 18-19, in two fractions). Twenty-three patients received concomitant cisplatin-based chemotherapy. The cumulative BEDs were calculated at Point A (BED10) and at bladder and rectal reference points (BED3) using the linear-quadratic equation. The BED10 values, after incorporating a time factor (BED10tf) in the formula, were also calculated. Results: In patients treated with RT alone, the local failure rate was 10{\%} (1 of 10) and 19{\%} (3 of 16) in patients receiving a BED10 >89 Gy10 or <89 Gy10 to Point A, respectively (p = 0.2). The corresponding local failure rates were 20{\%} (3 of 15) and 0{\%} (0 of 8) in patients treated with concomitant chemotherapy (p = 0.3). In patients treated with RT alone, the local failure rate was 7.7{\%} (1 of 13) and 23{\%} (3 of 13) in patients with a BED10tf >64 Gy10 or <64 Gy10 (p = 0.1), respectively. The median BED3 values at the rectal and bladder point was 95.5 Gy3 and 103.6 Gy3, respectively. Only 1 case of Grade 2 late rectal toxicity (2{\%}) and no late bladder toxicity occurred. Conclusion: In patients treated with RT alone, a BED10 >89 Gy and a BED10tf >64 Gy indicated a trend toward a better local control rate. This difference was not observed in patients receiving chemotherapy. A BED3 <100 Gy3 was associated with negligible late toxicity. Although the BED10 in our study was about 10-15 Gy10 less than that in the published data, the 4-year local control rate of 80{\%} and 83{\%} and disease-free survival rate of 75{\%} and 70{\%} with and without chemotherapy, respectively, compare well with the rates in other studies in the literature.",
keywords = "Biological equivalent dose, Cervical cancer, Linear-quadratic model, Radiation therapy",
author = "Brij Sood and Garg, {Madhur K.} and Jai Avadhani and Giridhar Gorla and Harish Malhotra and Chandan Guha and Shivaji Deore and Bhadrasain Vikram",
year = "2002",
month = "12",
day = "1",
doi = "10.1016/S0360-3016(02)03051-1",
language = "English (US)",
volume = "54",
pages = "1377--1387",
journal = "International Journal of Radiation Oncology Biology Physics",
issn = "0360-3016",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Predictive value of linear-quadratic model in the treatment of cervical cancer using high-dose-rate brachytherapy

AU - Sood, Brij

AU - Garg, Madhur K.

AU - Avadhani, Jai

AU - Gorla, Giridhar

AU - Malhotra, Harish

AU - Guha, Chandan

AU - Deore, Shivaji

AU - Vikram, Bhadrasain

PY - 2002/12/1

Y1 - 2002/12/1

N2 - Purpose: To determine whether a dose-response relationship exists between the biologic effective dose (BED) at Point A and the bladder and rectum and the clinical outcomes in our experience with external beam radiotherapy (EBRT) and high-dose-rate brachytherapy in the treatment of cervical carcinoma. Methods and Materials: This was a retrospective study. A total of 49 patients with cervical cancer were treated with a combination of EBRT (median 45 Gy, range 41.4-50.4) and high-dose-rate brachytherapy (median 18 Gy; range 18-19, in two fractions). Twenty-three patients received concomitant cisplatin-based chemotherapy. The cumulative BEDs were calculated at Point A (BED10) and at bladder and rectal reference points (BED3) using the linear-quadratic equation. The BED10 values, after incorporating a time factor (BED10tf) in the formula, were also calculated. Results: In patients treated with RT alone, the local failure rate was 10% (1 of 10) and 19% (3 of 16) in patients receiving a BED10 >89 Gy10 or <89 Gy10 to Point A, respectively (p = 0.2). The corresponding local failure rates were 20% (3 of 15) and 0% (0 of 8) in patients treated with concomitant chemotherapy (p = 0.3). In patients treated with RT alone, the local failure rate was 7.7% (1 of 13) and 23% (3 of 13) in patients with a BED10tf >64 Gy10 or <64 Gy10 (p = 0.1), respectively. The median BED3 values at the rectal and bladder point was 95.5 Gy3 and 103.6 Gy3, respectively. Only 1 case of Grade 2 late rectal toxicity (2%) and no late bladder toxicity occurred. Conclusion: In patients treated with RT alone, a BED10 >89 Gy and a BED10tf >64 Gy indicated a trend toward a better local control rate. This difference was not observed in patients receiving chemotherapy. A BED3 <100 Gy3 was associated with negligible late toxicity. Although the BED10 in our study was about 10-15 Gy10 less than that in the published data, the 4-year local control rate of 80% and 83% and disease-free survival rate of 75% and 70% with and without chemotherapy, respectively, compare well with the rates in other studies in the literature.

AB - Purpose: To determine whether a dose-response relationship exists between the biologic effective dose (BED) at Point A and the bladder and rectum and the clinical outcomes in our experience with external beam radiotherapy (EBRT) and high-dose-rate brachytherapy in the treatment of cervical carcinoma. Methods and Materials: This was a retrospective study. A total of 49 patients with cervical cancer were treated with a combination of EBRT (median 45 Gy, range 41.4-50.4) and high-dose-rate brachytherapy (median 18 Gy; range 18-19, in two fractions). Twenty-three patients received concomitant cisplatin-based chemotherapy. The cumulative BEDs were calculated at Point A (BED10) and at bladder and rectal reference points (BED3) using the linear-quadratic equation. The BED10 values, after incorporating a time factor (BED10tf) in the formula, were also calculated. Results: In patients treated with RT alone, the local failure rate was 10% (1 of 10) and 19% (3 of 16) in patients receiving a BED10 >89 Gy10 or <89 Gy10 to Point A, respectively (p = 0.2). The corresponding local failure rates were 20% (3 of 15) and 0% (0 of 8) in patients treated with concomitant chemotherapy (p = 0.3). In patients treated with RT alone, the local failure rate was 7.7% (1 of 13) and 23% (3 of 13) in patients with a BED10tf >64 Gy10 or <64 Gy10 (p = 0.1), respectively. The median BED3 values at the rectal and bladder point was 95.5 Gy3 and 103.6 Gy3, respectively. Only 1 case of Grade 2 late rectal toxicity (2%) and no late bladder toxicity occurred. Conclusion: In patients treated with RT alone, a BED10 >89 Gy and a BED10tf >64 Gy indicated a trend toward a better local control rate. This difference was not observed in patients receiving chemotherapy. A BED3 <100 Gy3 was associated with negligible late toxicity. Although the BED10 in our study was about 10-15 Gy10 less than that in the published data, the 4-year local control rate of 80% and 83% and disease-free survival rate of 75% and 70% with and without chemotherapy, respectively, compare well with the rates in other studies in the literature.

KW - Biological equivalent dose

KW - Cervical cancer

KW - Linear-quadratic model

KW - Radiation therapy

UR - http://www.scopus.com/inward/record.url?scp=0036890713&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036890713&partnerID=8YFLogxK

U2 - 10.1016/S0360-3016(02)03051-1

DO - 10.1016/S0360-3016(02)03051-1

M3 - Article

VL - 54

SP - 1377

EP - 1387

JO - International Journal of Radiation Oncology Biology Physics

JF - International Journal of Radiation Oncology Biology Physics

SN - 0360-3016

IS - 5

ER -