COMPARISON OF TWO RADIOTHERAPY TECHNIQUES IN TREATMENT OF PATIENTS WITH DIAGNOSED INOPERABLE CERVICAL CANCER

Petar Chakalaroski; Violeta Klisarova; Lenche Kostadinova; Angela Dameska; Aleksandra Adziska Mitkov; Olivera Ivanova

Petar Chakalaroski University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Violeta Klisarova University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Lenche Kostadinova University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Angela Dameska 1University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Aleksandra Adziska Mitkov 1University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia
Olivera Ivanova 1University Clinic of Radiotherapy and Oncology, Faculty of Medicine, Ss Cyril and Methodius University in Skopje, North Macedonia

Abstract

Advanced cervical cancer is treated with radiotherapy, target therapy, chemotherapy or a combination of those. Standardized accepted treatment of inoperable cervical cancer is concurrent chemo-radiotherapy (CCRT) followed by brachytherapy. Radiotherapy techniques used are three-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiation therapy (IMRT). In this study participated 30 female patients, average age of 52 at the time of irradiation.3D-CRT plans were made, patients were treated on linear accelerator (LINAC) with 3D-CRT. IMRT plans were made additionally. Planning target volume (PTV) dose coverage was 105.36% for 3D-CRT and 105.64% for IMRT. Homogeneity index (HI) was 0.062 for 3D-CRT and 0.048 for IMRT. Conformity index (CI) for 3D-CRT was 1.93 for PTV of 2990.77 ccm. CI for IMRT was 1.305 for PTV of 2019.83 ccm. Bladder V40 (%) for 3D-CRT averaged 96.61%, while IMRT averaged 73.11%. Rectal V50 (%) for 3D-CRT was 72.55% and for IMRT was 17.80%. Rectal V40 (%) for 3D-CRT and IMRT averaged 92.12% and 73.49% respectively. Quantitative Analysis of normal Tissue Effects in the Clinic (QUANTEC) â€“ V45 for 3D-CRT was 228.80ccm and for IMRT was 104.55ccm. Femoral heads dose for 3D-CRT was 51.50Gy for left and 51.29Gy for right. Absorbed doses for IMRT were 47.28Gy for left and 47.32Gy for right femoral head, respectively. 13 patients had grade 1 cystitis and urethritis, 2 with grade 2. 7 patients developed grade 1 diarrhea, 1 with grade 2. It can be concluded that dosimetrically IMRT is superior to 3D-CRT in patients treating cervical cancer.

Keywords: cervical cancer, 3D-CRT, IMRT.

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