Page 27 - ARNM-3-3

Advances in Radiotherapy
& Nuclear Medicine Brachytherapy versus external beam in local dose escalation

Table 4. Summary of cervix cancer studies
Authors Study n pts Treatment boost Target coverage Dose to OAR Main results
Assenholt Retr 11 IRT vs. IMRT IRT: IRT: IMRT was associated with
et al. 19 V100% 95% (78 – 99%); Rectum, D2cc 75 Gy (69 – 75); increased doses to OAR
D100 62 Gy (53 – 71); Sigmoid, D2cc 71 Gy (53 – 75); compared to IRT
D90 90 Gy (70 – 97); Bladder, D2cc 79 Gy (63 – 90)
V60 Gy 330 cc (200 – 476) IMRT:
IMRT: Rectum, D2cc 75 Gy (71 – 75);
V100% 98% (90 – 100%); Sigmoid, D2cc 75 Gy (70 – 75);
D100 71 Gy (70 – 84); Bladder, D2cc 90 Gy (63 – 90)
D90 92 Gy (84 – 96);
V60 Gy 550 cc (443 – 906)
Dahbi Retr 20 IRT vs. SRT IRT: IRT: IRT was significantly
et al. 20 CTV HR Mean D90 (Gy) 17; Mean rectum, D2cc 71.8; associated with better CTV
CTV IR Mean D90 (Gy) 7.5 Mean sigmoid, D2cc 67.9; HR coverage (17 vs. 8.32,
SRT: Mean bladder, D2cc 74.6 P=0.028), lower mean
CTV HR Mean D90 (Gy) 8.32; SRT: bladder D2cc (74.6 vs. 84.7,
CTV IR Mean D90 (Gy) 8.9 Mean rectum, D2cc 74.7; P=0.019), and lower mean
Mean sigmoid, D2cc 75.75; sigmoid D2cc (67.9 vs.
Mean bladder, D2cc 84.7 75.75, P=0.0173)
Dincer Retr N.A. IRT vs. SRT IRT: IRT: -
et al. 21 CTV HR Mean EQD2 D90 (Gy) 89.7; Mean EQD2 rectum, D2cc 70.7;
CTV IR Mean EQD2 D90 (Gy) 70.5 Mean EQD2 sigmoid, D2cc 65.7;
SRT: Mean EQD2 bladder, D2cc 86.4
CTV HR Mean EQD2 D90 (Gy) 82.9; SRT:
CTV IR Mean EQD2 D90 (Gy) 70.2 Mean EQD2 rectum, D2cc 70.8;
Mean EQD2 sigmoid, D2cc 73.6;
Mean EQD2 bladder, D2cc 81.4
Georg Retr 9 IRT vs. IMRT/ - - GTV doses were lower
et al. 22 IMPT with both IMRT and IMPT
compared to IRT.
The bowel volume receiving
60 Gy was twice as large
with IMRT compared to
IRT
Neumann Retr 11 IRT vs. CK IRT: IRT: RRS25 exceeded tolerable
et al. 23 D90 32±5.6; D2cc rectal wall, 76±17.4; dose constraints for the
D100 18.9±5; D2cc bladder wall, 101.2±26.1; walls of critical OARs.
V90 94.4±7.3; D2cc sigmoid wall, 70.5±12.4 D2cc values for the bladder,
V100 90.9±8.9 CK: rectum, and sigmoid were
CK: D2cc rectal wall, 71.4±7.6; similar between RRS70
D90 31±0.8; D2cc bladder wall, 83.9±10.3; and IRT
D100 24.3±3.7; D2cc sigmoid wall, 67.3±10.4
V90 99.4±0.8
V100 97.1±2.7
Otahal Retr 10 IRT vs. CK IRT: IRT: IRT was significantly
et al. 24 GTV D90 9.8; Mean rectum, D2cc 3.0; associated with improved
GTV D100 7.7; Mean sigmoid, D2cc 3.2; D90 GTV and D100 CTV
CTV IR D90 2.7; Mean bladder, D2cc 4.4 IR coverage.
CTV IR D100 1.7 CK: CK was significantly
CK: Mean rectum, D2cc 1.8; associated with greater
GTV D90 8.9; Mean sigmoid, D2cc 2.0; organ-sparing effects
GTV D100 7.8; Mean bladder, D2cc 3.3 compared to IRT
CTV IR D90 2.8;
CTV IR D100 0.6
(Cont’d...)

Volume 3 Issue 3 (2025) 19 doi: 10.36922/ARNM025160017