The impact of body mass index on rectal dose in locally advanced cervical cancer treated with high-dose-rate brachytherapy

Jihoon Lim, Blythe Durbin-Johnson, Richard K Valicenti, Matthew Mathai, Robin L Stern, Jyoti Mayadev

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: The impact of body mass index (BMI) on rectal dose in brachytherapy for cervical cancer is unknown. We assessed the association of BMI on rectal dose and lower gastrointestinal (GI) toxicity. Methods and Materials: Between 2007 and 2010, 51 patients with 97 brachytherapy planning images were reviewed. Volumetric measurements of the maximum percentage, mean percentage, dose to 2cc (D2cc), and dose to 1cc (D1cc) of the rectum, and the Internal Commission on Radiation Units and Measurement (ICRU) rectal point were recorded. Linear mixed effect models, analysis of variance, and regression analyses were used to determine the correlation between multiple observations or to detect a difference in the mean. The GI acute and late toxicity were prospectively recorded and retrospectively analyzed. Results: The average BMI (kg/m2) was 27.7 with a range of 17.4-46.6. Among the patients, 8% were morbidly obese, 25% obese, 25% overweight, 40% normal weight, and 2% underweight. The mean D1cc, D2cc, mean rectal dose (%), maximum rectal dose (%), and ICRU rectum was 3.03Gy, 2.78Gy, 20%, 60%, and 2.99Gy, respectively. On multivariate analysis, there was a significant decrease in the D1cc and D2cc rectal dose (p=0.016), ICRU rectal point dose (p=0.022), and mean rectal dose percentage (p=0.021) with an increase in BMI. There was, however, no statistically significant relationship between BMI and GI toxicity. Conclusions: Obesity decreases the rectal dose given in high-dose-rate brachytherapy for locally advanced cervical cancer because of an increase in fatty tissue in the recto-uterine space. There is no significant correlation between BMI and acute or late GI toxicity.

Original languageEnglish (US)
Pages (from-to)550-554
Number of pages5
JournalBrachytherapy
Volume12
Issue number6
DOIs
StatePublished - Nov 2013

Fingerprint

Brachytherapy
Uterine Cervical Neoplasms
Body Mass Index
Radiation
Rectum
Analysis of Variance
Thinness
Adipose Tissue
Multivariate Analysis
Obesity
Regression Analysis
Weights and Measures

Keywords

  • Brachytherapy
  • Cervical cancer
  • Rectal dose

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

The impact of body mass index on rectal dose in locally advanced cervical cancer treated with high-dose-rate brachytherapy. / Lim, Jihoon; Durbin-Johnson, Blythe; Valicenti, Richard K; Mathai, Matthew; Stern, Robin L; Mayadev, Jyoti.

In: Brachytherapy, Vol. 12, No. 6, 11.2013, p. 550-554.

Research output: Contribution to journalArticle

Lim, Jihoon ; Durbin-Johnson, Blythe ; Valicenti, Richard K ; Mathai, Matthew ; Stern, Robin L ; Mayadev, Jyoti. / The impact of body mass index on rectal dose in locally advanced cervical cancer treated with high-dose-rate brachytherapy. In: Brachytherapy. 2013 ; Vol. 12, No. 6. pp. 550-554.
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abstract = "Purpose: The impact of body mass index (BMI) on rectal dose in brachytherapy for cervical cancer is unknown. We assessed the association of BMI on rectal dose and lower gastrointestinal (GI) toxicity. Methods and Materials: Between 2007 and 2010, 51 patients with 97 brachytherapy planning images were reviewed. Volumetric measurements of the maximum percentage, mean percentage, dose to 2cc (D2cc), and dose to 1cc (D1cc) of the rectum, and the Internal Commission on Radiation Units and Measurement (ICRU) rectal point were recorded. Linear mixed effect models, analysis of variance, and regression analyses were used to determine the correlation between multiple observations or to detect a difference in the mean. The GI acute and late toxicity were prospectively recorded and retrospectively analyzed. Results: The average BMI (kg/m2) was 27.7 with a range of 17.4-46.6. Among the patients, 8{\%} were morbidly obese, 25{\%} obese, 25{\%} overweight, 40{\%} normal weight, and 2{\%} underweight. The mean D1cc, D2cc, mean rectal dose ({\%}), maximum rectal dose ({\%}), and ICRU rectum was 3.03Gy, 2.78Gy, 20{\%}, 60{\%}, and 2.99Gy, respectively. On multivariate analysis, there was a significant decrease in the D1cc and D2cc rectal dose (p=0.016), ICRU rectal point dose (p=0.022), and mean rectal dose percentage (p=0.021) with an increase in BMI. There was, however, no statistically significant relationship between BMI and GI toxicity. Conclusions: Obesity decreases the rectal dose given in high-dose-rate brachytherapy for locally advanced cervical cancer because of an increase in fatty tissue in the recto-uterine space. There is no significant correlation between BMI and acute or late GI toxicity.",
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AU - Lim, Jihoon

AU - Durbin-Johnson, Blythe

AU - Valicenti, Richard K

AU - Mathai, Matthew

AU - Stern, Robin L

AU - Mayadev, Jyoti

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N2 - Purpose: The impact of body mass index (BMI) on rectal dose in brachytherapy for cervical cancer is unknown. We assessed the association of BMI on rectal dose and lower gastrointestinal (GI) toxicity. Methods and Materials: Between 2007 and 2010, 51 patients with 97 brachytherapy planning images were reviewed. Volumetric measurements of the maximum percentage, mean percentage, dose to 2cc (D2cc), and dose to 1cc (D1cc) of the rectum, and the Internal Commission on Radiation Units and Measurement (ICRU) rectal point were recorded. Linear mixed effect models, analysis of variance, and regression analyses were used to determine the correlation between multiple observations or to detect a difference in the mean. The GI acute and late toxicity were prospectively recorded and retrospectively analyzed. Results: The average BMI (kg/m2) was 27.7 with a range of 17.4-46.6. Among the patients, 8% were morbidly obese, 25% obese, 25% overweight, 40% normal weight, and 2% underweight. The mean D1cc, D2cc, mean rectal dose (%), maximum rectal dose (%), and ICRU rectum was 3.03Gy, 2.78Gy, 20%, 60%, and 2.99Gy, respectively. On multivariate analysis, there was a significant decrease in the D1cc and D2cc rectal dose (p=0.016), ICRU rectal point dose (p=0.022), and mean rectal dose percentage (p=0.021) with an increase in BMI. There was, however, no statistically significant relationship between BMI and GI toxicity. Conclusions: Obesity decreases the rectal dose given in high-dose-rate brachytherapy for locally advanced cervical cancer because of an increase in fatty tissue in the recto-uterine space. There is no significant correlation between BMI and acute or late GI toxicity.

AB - Purpose: The impact of body mass index (BMI) on rectal dose in brachytherapy for cervical cancer is unknown. We assessed the association of BMI on rectal dose and lower gastrointestinal (GI) toxicity. Methods and Materials: Between 2007 and 2010, 51 patients with 97 brachytherapy planning images were reviewed. Volumetric measurements of the maximum percentage, mean percentage, dose to 2cc (D2cc), and dose to 1cc (D1cc) of the rectum, and the Internal Commission on Radiation Units and Measurement (ICRU) rectal point were recorded. Linear mixed effect models, analysis of variance, and regression analyses were used to determine the correlation between multiple observations or to detect a difference in the mean. The GI acute and late toxicity were prospectively recorded and retrospectively analyzed. Results: The average BMI (kg/m2) was 27.7 with a range of 17.4-46.6. Among the patients, 8% were morbidly obese, 25% obese, 25% overweight, 40% normal weight, and 2% underweight. The mean D1cc, D2cc, mean rectal dose (%), maximum rectal dose (%), and ICRU rectum was 3.03Gy, 2.78Gy, 20%, 60%, and 2.99Gy, respectively. On multivariate analysis, there was a significant decrease in the D1cc and D2cc rectal dose (p=0.016), ICRU rectal point dose (p=0.022), and mean rectal dose percentage (p=0.021) with an increase in BMI. There was, however, no statistically significant relationship between BMI and GI toxicity. Conclusions: Obesity decreases the rectal dose given in high-dose-rate brachytherapy for locally advanced cervical cancer because of an increase in fatty tissue in the recto-uterine space. There is no significant correlation between BMI and acute or late GI toxicity.

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