Image-based brachytherapy for cervical cancer

Table 1 Discrepancies between bladder and rectal doses as assessed by two-dimensional orthogonal films and computed tomography-image based planning

	Orthogonal film based vs	CT based
Ling et al[19]	Bladder	1.0 - 4.1x
	Rectum	1.4 - 2.5x
Schoeppel et al[20]	Bladder	2.1 - 2.3x
	Rectum	1.3 – 1.6x
Stuecklschweiger et al[21]	Bladder	1.0 - 2.2x
	Rectum	1.1 - 1.6x
Kapp et al[22]	Bladder	1.0 – 5.4x
	Rectum	1.1 – 2.7x

Table 2 Dosimetric correlates for rectal toxicity in image-based brachytherapy

	D2cc (mean)	D1cc (mean)	D0.1cc (mean)
Koom et al[24] VRS ≥ 2	75 Gy vs 69 Gy (P = 0.02)	80 Gy vs 73 Gy (P = 0.02)	90 Gy vs 85 Gy (P = 0.04)
Georg et al[25] VRS ≥ 3	72 Gy vs 62 Gy (P < 0.001)	76 Gy vs 65 Gy (P < 0.001)	88 Gy vs 75 Gy (P = 0.002)
Georg et al[26] Symptomatic	72 Gy vs 64 Gy (P < 0.01)	76 Gy vs 67 Gy (P < 0.01)	88 Gy vs 77 Gy (P = 0.03)

VRS: Vienna rectoscopy score; cc: Cubic centimeters; Gy: Gray; D2cc: Dose to 2 cubic centimeters.

Table 3 Correlations for volumetric doses for risk of grade 2+ late toxicity

	5% Risk	10% Risk	20% Risk	P value
Rectum
D2cc	67	78	90	0.0178
D1cc	71	87	104	0.0352
D0.1cc	83	132	186	0.1364
Bladder
D2cc	70	101	134	0.0274
D1cc	71	116	164	0.0268
D0.1cc	61	178	305	0.0369

D2cc: Dose to 2 cubic centimeters; D1cc: Dose to 1 cubic centimeter; D0.1cc: Dose to 0.1 cubic centimeter.

Table 4 Summary of clinical outcomes in published results for image-based brachytherapy for cervical cancer

	Local control	Disease free survival	Overall survival	Late toxicity (G3+)
STIC[47] (2-yr)	78.5%-100%	60.3%-89.7%	74%-96%	2.6%-8.9%
Vienna[39] (3-yr)	95%	74%	68%	7.7% crude
Pittsburgh[48] (2-yr)	90%	NR	82%	2%
Paris[49] (4-yr)	91%	86%	94%	0%
Addenbrooke[41] (3-yr)	96%	81%	82%	11% crude (14% actuarial)
Australia[50] (5-yr)	87%-88%	67%	60%	0.6%-4.6%
Korea[51] (3-yr)	97%	80%	NR	2%

NR: Not-reported; G3+: Grade ≥ 3 toxicity.