Advances in Radiation Oncology (May 2022)

Effect of Hyaluronate Acid Injection on Dose-Volume Parameters in Brachytherapy for Cervical Cancer

  • Rei Kobayashi, MD, PhD,
  • Naoya Murakami, MD, PhD,
  • Takahito Chiba, MS,
  • Kae Okuma, MD, PhD,
  • Koji Inaba, MD, PhD,
  • Kana Takahashi, MD, PhD,
  • Tomoya Kaneda, MD, PhD,
  • Tairo Kashihara, MD, PhD,
  • Ayaka Takahashi, MD,
  • Yuri Shimizu, MD, PhD,
  • Yuko Nakayama, MD, PhD,
  • Tomoyasu Kato, MD, PhD,
  • Yoshinori Ito, MD, PhD,
  • Hiroshi Igaki, MD, PhD

Journal volume & issue
Vol. 7, no. 3
p. 100918

Abstract

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Purpose: Hyaluronate gel has been injected as a spacer into the rectovaginal fossa and vesicouterine fossa during brachytherapy for patients with cervical cancer at our institution. The effect of hyaluronate gel injection (HGI) on dose-volume parameters was investigated in this study. Methods and Materials: Between July 2008 to January 2020, a total of 104 patients (non-HGI group: 52 patients; HGI group: 52 patients) who underwent curative radiation therapy for cervical cancer were selected. The total doses of external beam radiation therapy and brachytherapy for high-risk clinical target volume (CTVHR) D90, bladder D2cc, and rectal D2cc were converted to the equivalent dose in 2 Gy fractions (EQD2) and were analyzed for association with HGI. Results: Median CTVHR D90 (EQD2) in the non-HGI group was 76.0 Gy (63.7-99.5 Gy), and in the HGI group it was 79.4 Gy (52.6-97.5 Gy) (P = .017). The median bladder D2cc and rectal D2cc (EQD2) were 62.9 Gy and 56.0 Gy in the non-HGI group and 63.7 Gy and 54.8 Gy in the HGI group, which had no significant difference. Conclusions: In cases with HGI, a significant CTVHR D90 dose increase was obtained with sufficient bladder and rectal doses suppression.