Clinical Tumor Dimensions May Be Useful to Prevent Geographic Miss in Conventional Radiotherapy of Uterine Cervix Cancer—A Magnetic Resonance Imaging–Based Study

Justino, Pitágoras Baskara; Baroni, Ronaldo Hueb; Blasbalg, Roberto; Carvalho, Heloísa de Andrade

doi:10.1016/j.ijrobp.2008.08.005

Cited by 7 publications

(8 citation statements)

References 25 publications

(29 reference statements)

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“…The median age observed was similar to the ones found in other studies including patients with the same disease (9,11) . Thus the present results corroborate the literature, except for those related to predominant histological grades, since studies evaluating the utilization of MRI in radiotherapy planning have not taken this parameter into consideration (7,12,13) .…”

Section: Discussionsupporting

confidence: 90%

“…In the present study, a significant relation was observed between field border inappropriateness and anteroposterior tumor diameter, displacement of the anterior rectal wall, and tumor volume. The authors suggest that such factors can be utilized as risk predictors of geographic miss (13) .…”

Section: Discussionmentioning

confidence: 99%

“…This finding may be correlated with the fact that higher histological grades are associated with more advanced or more voluminous tumors. In the reviewed literature on radiotherapy field borders appropriateness evaluation with MRI, the authors have not evaluated this factor in relation to geographic miss (7,12,13) .…”

Section: Discussionmentioning

confidence: 99%

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Ressonância magnética para avaliação dos limites dos campos clássicos de radioterapia em pacientes portadoras de neoplasia maligna de colo uterino

et al. 2010

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OBJETIVO: Avaliar os limites de campo padronizados para radioterapia de neoplasia maligna de colo uterino com o uso de ressonância magnética e verificar a importância deste exame na redução de possíveis erros de planejamento com técnica convencional. MATERIAIS E MÉTODOS: Foram analisados, retrospectivamente, exames de ressonância magnética do planejamento de 51 pacientes tratadas devido a neoplasia de colo uterino. Os parâmetros estudados foram limites anterior e posterior no corte sagital. RESULTADOS: Observou-se, no corte sagital das ressonâncias magnéticas, que o limite de campo anterior apresentou-se inadequado em 20 (39,2%) pacientes e que houve perda geográfica em 37,3% dos casos no limite posterior. A inadequação de ambos os limites de campo não se relacionou com parâmetros clínicos como idade das pacientes, estadiamento, tipo e grau histológico. CONCLUSÃO: A avaliação dos limites de campo padronizados pela literatura com o uso de ressonância magnética mostrou altos índices de inadequação dos limites do campo lateral, assim como a importância do uso deste exame no planejamento radioterápico de pacientes portadoras de câncer de colo uterino com a finalidade de reduzir a perda geográfica no volume alvo de tratamento.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Ressonância magnética para avaliação dos limites dos campos clássicos de radioterapia em pacientes portadoras de neoplasia maligna de colo uterino

et al. 2010

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“…[10][11][12] With the use of sectional imaging, wide variations such as different levels of aortic bifurcation, altered sacral curvature, and varying course of pelvic vessels have been reported in the pelvic anatomy of individual patients as well. [13][14][15] This has led to development of modern techniques such as 3 dimensional conformal radiotherapy and intensity-modulated radiotherapy. These newer techniques have reported decrease in normal tissue toxicity, along with decrease in the chances of geographic miss.…”

Section: Bpkmch Nepalese Journal Of Cancer (Njc)mentioning

confidence: 99%

Comparative Study of Treatment Response and Toxicity of Four Field Box Technique Versus Two Field Technique External Beam Radiotherapy in Locally Advanced Carcinoma Cervix

Shrestha

Acharya

2019

Nep. J. Cancer

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Introduction: External beam radiotherapy plays a pivotal role in locally advanced carcinoma cervix. EBRT treats the whole pelvis including the primary tumor along with the regional lymph nodes. Conventionally, EBRT planning is based on standard bony landmarks using X-rays and can be delivered by anterior–posterior and posterior–anterior (AP-PA) parallel opposed fields or the four field box technique. AP-PA field technique provides good coverage to the target volume. Four field box technique with parallel opposed AP-PA fields and two lateral opposed fields although has better dose distribution and decrease normal tissue toxicity, is time consuming. EBRT by AP-PA two field technique is generally used in our center due to less manpower and resources and huge load of patients. But, pelvic radiotherapy by 4 field portals has been proven by the trials that it has better tumor response. So, the objective of this study was to compare the tumor response and acute hematological and non- hematological toxicities between the two techniques. Methods: One hundred and twenty patients with diagnosis of carcinoma cervix were enrolled in this study, sixty assigned in each group. Group A received radiation by AP-PA two field technique and Group B by 4 field box technique. Chemotherapy regimen was the same for the two groups. Treatment response and toxicities were evaluated after the completion of treatment and compared between two groups. Results: All enrolled patients received planned treatment. The total duration of treatment in both the groups was 23 days. Loco-regional control with complete remission was 63.3 % in group A Vs. 73.3% in group B (p= 0.405). Acute toxicities of grade 1 and grade 2 were seen more in group A compared to group B, nausea (63.3% vs. 56.7% p=0.141), vomiting (13.3% vs. 20% p=0.234), diarrhea (10% vs. 6.7%), radiation dermatitis (3.3% vs. 0%). Hematological toxicities like anemia, thrombocytopenia and leucopenia were observed more ingroup A than group B. Conclusion: Both two and four field box techniques are equally effective and feasible as statistically insignificant difference in the response rate and acute toxicities was observed in the two groups.

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“…Variations include different levels of aortic bifurcation, altered sacral curvature, and varying course of pelvic vessels. [123] These have raised concerns over the adequate coverage of the target volume with conventional two-dimensional fields based on standard bony landmarks.…”

Section: Introductionmentioning

confidence: 99%

Conventional four field radiotherapy versus computed tomography-based treatment planning in cancer cervix: A dosimetric study

Gulia¹,

Patel²,

Rai³

et al. 2013

South Asian J Cancer

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Background:With advancements in imaging, wide variations in pelvic anatomy have been observed, thus raising doubts about adequate target volume coverage by conventional external radiotherapy fields based on bony landmarks. The present study evaluates the need for integrating computed tomography (CT)-based planning in the treatment of carcinoma cervix.Aims:To estimate inadequacies in target volume coverage when using conventional planning based on bony landmarks.Materials and Methods:The study consisted of 50 patients. Target volume delineation was done on planning CT scans, according to the guidelines given in literature. The volume of target receiving 95% of prescribed dose (V95) was calculated after superimposing a conventional four field box on digitally reconstructed radiograph. The geographic miss with conventional four field box technique was compared with the CT-based target volume delineation.Results:In 48 out of 50 patients, the conventional four field box failed to encompass the target volume. The areas of miss were at the superior and lateral borders of the anterior-posterior fields, and the anterior border of the lateral fields. The median V95 for conventional fields marked with bony landmarks was only 89.4% as compared to 93% for target delineation based on CT contouring.Conclusions:Our study shows inadequate target volume coverage with conventional four field box technique. We recommend routine use of CT-based planning for treatment with radiotherapy in carcinoma cervix.

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Clinical Tumor Dimensions May Be Useful to Prevent Geographic Miss in Conventional Radiotherapy of Uterine Cervix Cancer—A Magnetic Resonance Imaging–Based Study

Cited by 7 publications

References 25 publications

Ressonância magnética para avaliação dos limites dos campos clássicos de radioterapia em pacientes portadoras de neoplasia maligna de colo uterino

Ressonância magnética para avaliação dos limites dos campos clássicos de radioterapia em pacientes portadoras de neoplasia maligna de colo uterino

Comparative Study of Treatment Response and Toxicity of Four Field Box Technique Versus Two Field Technique External Beam Radiotherapy in Locally Advanced Carcinoma Cervix

Conventional four field radiotherapy versus computed tomography-based treatment planning in cancer cervix: A dosimetric study

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