PMID- 12627263
OWN - NLM
STAT- MEDLINE
DCOM- 20030421
LR  - 20181130
IS  - 0179-7158 (Print)
IS  - 0179-7158 (Linking)
VI  - 179
IP  - 3
DP  - 2003 Mar
TI  - Comparison between in vivo dosimetry and barium contrast technique for prediction 
      of rectal complications in high-dose-rate intracavitary radiotherapy in cervix 
      cancer patients.
PG  - 191-6
AB  - PURPOSE: To investigate the correlation between late rectal complications and 
      rectal dose in cervix cancer patients treated with high-dose-rate intracavitary 
      radiotherapy (HDR ICR) and to analyze factors reducing rectal complications. 
      PATIENTS AND METHODS: A total of 136 patients with cervix cancer who were treated 
      with external beam radiotherapy (EBRT) and HDR ICR from 1995 to 1999 were 
      retrospectively analyzed. Radiotherapy (RT) consisted of EBRT plus HDR ICR. The 
      median EBRT dose was 50.4 Gy, and midline block was done after 30-50 Gy of EBRT. 
      A total of six fractions of HDR ICR with 4 Gy fraction size each were applied 
      twice per week to the A point. The rectal dose was calculated at the rectal 
      reference point using the barium contrast criteria. In vivo measurement of the 
      rectal dose was performed with thermoluminescent dosimeter (TLD) during HDR ICR. 
      The median follow-up period was 26 months (range 6-60 months). RESULTS: A total 
      of 16 patients (12%) experienced rectal bleeding, which occurred 4-33 months 
      (median 11 months) after the completion of RT. The calculated rectal doses did 
      not differ in patients with rectal bleeding and those without, but the measured 
      rectal doses were higher in affected patients. The differences of the measured 
      ICR fractional rectal dose, ICR total rectal dose, and total rectal biologically 
      equivalent dose (BED) were statistically significant. When the measured ICR total 
      rectal dose exceeded 16 Gy, the ratio of the measured rectal dose to A point dose 
      was > 70%; when the measured rectal BED exceeded 110 Gy(3), a high possibility of 
      late rectal complications could be found. CONCLUSION: In vivo dosimetry using TLD 
      during HDR ICR was a good predictor of late rectal complications. Hence, if data 
      from in vivo dosimetry shows any possibility of rectal bleeding, efforts should 
      be made to reduce the rectal dose.
FAU - Huh, Seung Jae
AU  - Huh SJ
AD  - Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University 
      School of Medicine, Seoul, Korea.
FAU - Lim, Do Hoon
AU  - Lim DH
FAU - Ahn, Yong Chan
AU  - Ahn YC
FAU - Lee, Jeong Eun
AU  - Lee JE
FAU - Kang, Min Kyu
AU  - Kang MK
FAU - Shin, Seong Soo
AU  - Shin SS
FAU - Shin, Kyung Hwan
AU  - Shin KH
FAU - Kim, Bokyung
AU  - Kim B
FAU - Park, Won
AU  - Park W
FAU - Han, Youngyih
AU  - Han Y
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - Germany
TA  - Strahlenther Onkol
JT  - Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et 
      al]
JID - 8603469
RN  - 25BB7EKE2E (Barium Sulfate)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Barium Sulfate
MH  - Brachytherapy/*adverse effects
MH  - Dose Fractionation, Radiation
MH  - Female
MH  - Fluoroscopy
MH  - Follow-Up Studies
MH  - Gastrointestinal Hemorrhage/*etiology
MH  - Humans
MH  - Middle Aged
MH  - Radiation Dosage
MH  - Radiotherapy Dosage
MH  - Rectal Diseases/*etiology
MH  - Rectum/diagnostic imaging/*radiation effects
MH  - Retrospective Studies
MH  - *Thermoluminescent Dosimetry
MH  - Time Factors
MH  - Uterine Cervical Neoplasms/*radiotherapy
EDAT- 2003/03/11 04:00
MHDA- 2003/04/22 05:00
CRDT- 2003/03/11 04:00
PHST- 2003/03/11 04:00 [pubmed]
PHST- 2003/04/22 05:00 [medline]
PHST- 2003/03/11 04:00 [entrez]
AID - 10.1007/s00066-003-1015-2 [doi]
PST - ppublish
SO  - Strahlenther Onkol. 2003 Mar;179(3):191-6. doi: 10.1007/s00066-003-1015-2.