Clinical efficacy and toxicity of radio-chemotherapy and magnetic resonance imaging-guided brachytherapy for locally advanced cervical cancer patients: A mono-institutional experience

Abstract

(2015) Clinical efficacy and toxicity of radio-chemotherapy and magnetic resonance imaging-guided brachytherapy for locally advanced cervical cancer patients: A mono-institutional experience, Acta Oncologica, 54:9, 1558Oncologica, 54:9, -1566 , cancer-specifi c survival (CCS) and overall survival (OS) were analyzed actuarially and morbidity crude rates were scored using CTCAEv4.0.Results . Mean follow-up was 36 months (range 6 -94). The mean D90 and D98 for HR-CTV was 84.4 Ϯ 9 Gy and 77 Ϯ 8.1 Gy, while for IR-CTV was 69.1 Ϯ 4.3 Gy and 64.8 Ϯ 4.3 Gy, respectively. The mean D2cm ³ for OARs was the following: bladder: 77.3 Ϯ 10.5 Gy, rectum: 65 Ϯ 6.8 Gy, sigmoid: 63 Ϯ 7.9 Gy and intestine: 64.0 Ϯ 9.1 Gy. Three year LC, CSS and OS were: 94%, 85% and 81%. The three-year regional-and distant control rates were 95% and 74%. Node negative patients had signifi cantly higher three-year CSS (100 vs. 72%, p ϭ 0.016) and OS (92 vs. 72%, p ϭ 0.001) compared to node positive ones. Three-year actuarial late Grade Ն 3 morbidity was the following: GI: 8%, GU: 5%, Vaginal: 8%. The frequency of Grade Ն 3 hematological toxicities including anemia/leukopenia/neutropenia/thrombocytopenia were 8.6%/34.7%/24.3%/24.3%, respectively. Conclusion. This large mono-institutional experience builds up further evidences that IGABT in conjunction with RCT should be the standard of care for patients suffering LACC.

Dose–volume effect relationships for late rectal morbidity in patients treated with chemoradiation and MRI-guided adaptive brachytherapy for locally advanced cervical cancer: Results from the prospective multicenter EMBRACE study

“…the organs at risk (OAR), as well as optimized 3D treatment planning based on dose-volume histograms. Recent monocentric series showed high local control rates with promising results and only limited to moderate morbidity in regard to classical outcomes from historical cohorts [3][4][5][6][7][8][9][10].…”

IMRT and brachytherapy comparison in gynaecological cancer treatment: thinking over dosimetry and radiobiology

“…Finally, quite large margins that are necessary for IMRT planning might lead to unnecessary overdosing of healthy tissues while the tumour shrinks as a consequence of the therapy. Moreover, uncertainties due to intrafraction variations can contribute to the treatment-related late side [57]. It should be taken into account that as ICBRT necessitates a dedicated brachytherapy unit and costly periodic source changes, IMRT should be applied with a brachytherapy-like immobilisation system and irradiation should be always image-guided delivered.…”

Clinical outcome in prostate cancer treated with magnetic resonance imaging-guided high-dose-rate brachytherapy combined with external beam radiotherapy

“…To date only few long-term clinical results are available on MR guided-HDRBT [12,13,[15][16][17] as reports primarily focus on clinical workflow, feasibility and cohort sizes, follow-up times are too short to address the clinical efficacy. We aimed to report a five-year clinical outcome with MRI-only HDRBT boost for IRPC and HRPC patients.…”

“…The clinical efficacy of MR-guided BT has been well demonstrated in gynecologic tumors [13,14], however, only few long-term clinical results are available for MR-guided highdose-rate prostate BT (HDRBT) [12,[15][16][17][18][19][20][21]. We introduced MRonly prostate HDRBT boost in 2007 [18,19] and now we report the five-year clinical efficacy, late toxicity and quality of life (QoL).…”

“…2009;27:1160-1167. [13] Polley M-YC, Leung SCY, McShane LM, et al An international Ki67 reproducibility study. J Natl Cancer Inst.…”