Dosimetric Comparison And Early Clinical Outcomes On Simultaneous Modulated Accelerated Radiotherapy And Intensity Modulated Radiation Therapy In The Treatment Of Locally Advanced Cervical Carcinoma

Objective：Whole pelvis intensity modulated radiotherapy (IMRT)is increasingly being used to treat cervical cancer aiming toreduce side effects. Encouraged by this, some groups haveproposed the use of simultaneous integrated boost (SIB) totarget the tumor, either to get a higher tumoricidal effect.Thepurpose is to study the difference in dosimetric characteristicsand early clinical outcomes on Simultaneous ModulatedAccelerated Radiotherapy （SMART） and Intensity ModulatedRadiation Therapy (IMRT) in the Treatment of locally advancedcervical carcinoma.Methods：Select32cases of locally advanced cervical cancerpatients of the Radiotherapy Department as the researchobject.All patients were in clinical stage II B and above, andimaging confirmed no distant metastasis.13patients werevolentary to participate in the SMART group,whose prescribeddose for PTV was50.4Gy/28f, while dose for GTV-SIB was boostedto60Gy/28f.19patients were volentary to participate in the IMRT group,whose prescribed dose for PTV was50.4Gy/28f. Bothgroups received concurrent chemothrapy(cisplatin40mg/㎡).TheSMART and IMRT plans of the10patients are designed respectively.Conformity index(CI), isodose line and dose volumehistogram(DVH) were used to evaluate the dose distribution intumor and OARs.Acute toxicity and efficacy with the32caseswould be evaluated.Results：The mean dose of gross tumor volume of SMART plan werebetter than those of IMRT（p=0.000）.The dose distribution CI,thevolume of rectum,bladder at20,30,40,50Gy and the mean dose ofrectum,bladder in SMART plan and IMRT plan have no statisticsignificances. The CR and PR rates in SMART group and IMRT groupwere respectively84.6%vs78.9%and15.4%vs15.8%（P=0.699＞0.05）. Early gastrointestinal reactions (p=0.939), urinarytract reaction (p=0.722) and bone marrow (p=0.936) of the twogroups were not statistically significant.