title: Toxicities and dose-volume histogram parameters of MRI-based brachytherapy for cervical cancer.
abstract: To analyze the toxicities and dose-volume histogram parameters of external-beam and magnetic resonance imaging-based intracavitary brachytherapy in cervical cancer patients.
  
  
  
  Acute and late toxicities were assessed in 135 patients divided into four groups: group 1, grade 0; group 2, grades 1-4; group 3, grades 0-1; and group 4, grades 2-4. The doses at the International Commission on Radiation Units and Measurements (DICRU) and minimum doses to the most exposed 0.1, 1, 2, and 5 cc (D0.1cc, D1cc, D2cc, and D5cc) of normal organs were calculated as equivalent doses in 2 Gy (α/β = 3).
  
  
  
  The median follow-up was 35.2 months. For rectum, DICRU, D0.1cc, D1cc, and D2ccwere significantly different between groups 1 and 2 and DICRU, D0.1cc, and D1ccbetween groups 3 and 4. For bladder, D0.1cc, D1cc, and D2ccwere significantly different between groups 1 and 2 and DICRU, D1cc, D2cc, and D5ccbetween groups 3 and 4. Grade 2-4 bladder toxicity occurred in fewer patients with D2cc≤ 95 Gy than those with D2cc> 95 Gy (7% vs. 22%, p = 0.014).
  
  
  
  DICRU, D0.1cc, D1cc, and D2ccare relevant for predicting late rectal toxicities. The patients with bladder D2cc> 95 Gy are required to be in close observation for severe late toxicities.
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Youngkyong
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea; Center for Uterine Cancer, National Cancer Center, Goyang, Republic of Korea. Electronic address: jane2000md@gmail.com.
authors.forename: Yeon-Joo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea; Center for Uterine Cancer, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Joo-Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Young Kyung
authors.initials: YK
authors.lastname: Lim
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Chiyoung
authors.initials: C
authors.lastname: Jeong
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Jonghwi
authors.initials: J
authors.lastname: Jeong
authors.affiliation: Proton Therapy Center, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Meyoung
authors.initials: M
authors.lastname: Kim
authors.affiliation: Center for Uterine Cancer, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Myong Cheol
authors.initials: MC
authors.lastname: Lim
authors.affiliation: Center for Uterine Cancer, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Sang-Soo
authors.initials: SS
authors.lastname: Seo
authors.affiliation: Center for Uterine Cancer, National Cancer Center, Goyang, Republic of Korea.
authors.forename: Sang-Yoon
authors.initials: SY
authors.lastname: Park
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D018196:Carcinoma, Adenosquamous / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D003556:Cystitis / Q000453:epidemiology / Q000209:etiology; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000453:epidemiology / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D058958:Organs at Risk / Q000000981:diagnostic imaging; D011832:Radiation Injuries / Q000453:epidemiology* / Q000209:etiology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D012007:Rectum / Q000000981:diagnostic imaging; D001743:Urinary Bladder / Q000000981:diagnostic imaging; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*
keywords: Brachytherapy; Cervical neoplasms; DVH parameters; Magnetic resonance imaging; Toxicity