Computed Tomography-Based High-Dose-Rate Intracavitary Brachytherapy for Uterine Cervical Cancer: Preliminary Demonstration of Correlation Between Dose-Volume Parameters and Rectal Mucosal Changes Observed by Flexible Sigmoidoscopy

Woong Sub Koom, Dae Kyung Sohn, Joo Young Kim, Jong Won Kim, Kyung Hwan Shin, Sang Min Yoon, Dae Yong Kim, Myonggeun Yoon, Dongho Shin, Sung Yong Park, Kwan Ho Cho

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Purpose: To compare the dose-volume histogram (DVH) parameters obtained by three-dimensional gynecologic brachytherapy planning with the rectosigmoid mucosal changes observed by flexible sigmoidoscopy. Methods and Materials: Between January 2004 and July 2005, 71 patients with International Federation of Gynecology and Obstetrics Stage IB-IIIB uterine cervical cancer underwent computed tomography-based high-dose-rate intracavitary brachytherapy. The total dose (external beam radiotherapy [RT] plus intracavitary brachytherapy) to the International Commission of Radiation Units and Measurements rectal point (ICRURP) and DVH parameters for rectosigmoid colon were calculated using the equivalent dose in 2-Gy fractions (α/β = 3 Gy). Sigmoidoscopy was performed every 6 months after RT, with the 6-scale scoring system used to determine mucosal changes. Results: The mean values of the DVH parameters and ICRURP were significantly greater in patients with a score of ≥2 than in those with a score <2 at 12 months after RT (ICRURP, 71 Gyα/β3 vs. 66 Gyα/β3, p = 0.02; D0.1cc, 93 Gyα/β3 vs. 85 Gyα/β3, p = 0.04; D1cc, 80 Gyα/β3 vs. 73 Gyα/β3, p = 0.02; D2cc, 75 Gyα/β3 vs. 69 Gyα/β3, p = 0.02). The probability of a score of ≥2 showed a significant relationship with the DVH parameters and ICRURP (ICRURP, p = 0.03; D0.1cc, p = 0.05; D1cc, p = 0.02; D2cc, p = 0.02). Conclusion: Our preliminary data have shown that DVH values of the rectosigmoid colon obtained by computed tomography-based three-dimensional brachytherapy planning are reliable and predictive of score ≥2 rectosigmoid mucosal changes.

Original languageEnglish
Pages (from-to)1446-1454
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number5
Publication statusPublished - 2007 Aug 1
Externally publishedYes



  • Computed tomography-based brachytherapy
  • Dose-volume parameters
  • ICRU rectal point
  • Mucosal change
  • Sigmoidoscopy

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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