Comparison of intracavitary brachytherapy and stereotactic body radiotherapy dose distribution for cervical cancer

Cengiz, Mustafa; Dogan, A.; Özyiğit, Gökhan; Erturk, E.; Yıldız, Ferah; Selek, Uğur; Ülger, Şükran; Çolak, Fatma; Zorlu, Faruk

doi:10.1016/j.brachy.2011.12.001

Cited by 48 publications

(30 citation statements)

References 23 publications

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“…For instance, Cengiz et al generated SBRT plans for 11 stage IIB cervical cancer patients and compared the dose distributions with those delivered using BT. The rectal dose to 1 cc (d 1cc ) was (5.09 vs. 6.05 Gy, P=0.02), the bladder d 1cc (6.78 vs. 8.76 Gy, P=0.04) and the median target coverage by the 100% isodose line was (99.1% vs. 50.7%, P<0.05); all favoring SBRT plans (the study however was limited by BT dose prescription to point A) (41). Similarly, the volumetric modulated arc therapy (VMAT) dosimetric plans [generated for 51 gynecologic cancer patients receiving the initial 45-50.4 Gy via three dimensional conformal radiotherapy (3DCRT) and a boost of 6 Gy for maximum dose (d max ) with comparable bladder and bowel dose; however, the integral dose and the PTV coverage favored BT (44).…”

Section: Newer Techniques May Offer Dose Distribution Not Exceedinglymentioning

confidence: 95%

See 1 more Smart Citation

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Mahmoud¹,

Kilic²,

Khan³

et al. 2017

Ann. Transl. Med.

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The management of locally advanced cervical cancer relies on brachytherapy (BT) as an integral part of the radiotherapy delivery armamentarium. Occasionally, intracavitary BT is neither possible nor available. In these circumstances, post-external beam radiotherapy (EBRT) interstitial brachytherapy and/or hysterectomy may represent viable options that must be adequately executed in a timely manner. However, if these options are not applicable due to patient related or facility related reasons, a formal contingency plan should be in place. Innovative EBRT techniques such as intensity modulated and stereotactic radiotherapy may be considered for patients unable to undergo brachytherapy. Relying on provocative arguments and recent data, this review explores the rationale for and limitations of non-brachytherapy substitutes in that setting aiming to establish a formal process for the optimal execution of this alternative plan.

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Section: Newer Techniques May Offer Dose Distribution Not Exceedinglymentioning

confidence: 95%

“…A number of dosimetric studies advocated superior target coverage and sparing of organs at risk in favor of SBRT (41)(42)(43). For instance, Cengiz et al generated SBRT plans for 11 stage IIB cervical cancer patients and compared the dose distributions with those delivered using BT.…”

Section: Newer Techniques May Offer Dose Distribution Not Exceedinglymentioning

confidence: 99%

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Mahmoud¹,

Kilic²,

Khan³

et al. 2017

Ann. Transl. Med.

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“…Comparative planning studies showed good dose coverage of the target volumes by stereotactic techniques [20]. Low toxicity and favorable early tumor control has been reported for such an approach in patients who could not undergo brachytherapy [21].…”

Section: Developments In External-beam Radiotherapy Brachytherapy Amentioning

confidence: 99%

Radiotherapy of Cervical Cancer

Vordermark

2016

Oncol Res Treat

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Curative-intent radical radiotherapy of cervical cancer consists of external-beam radiotherapy, brachytherapy, and concomitant chemotherapy with cisplatin. For each element, new developments aim to improve tumor control rates or treatment tolerance. Intensity-modulated radiotherapy (IMRT) has been shown to reduce gastrointestinal toxicity and can be used to selectively increase the radiotherapy dose. Individualized, image-guided brachytherapy enables better adaptation of high-dose volumes to the tumor extension. Intensification of concomitant or sequential systemic therapy is under evaluation.

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“…The precisely distributed dose also gives the opportunity to spare the normal tissues in vicinity. In a dosimetric study performed by Cengiz et al 17 , when compared to high dose rate brachytherapy, SBRS plans had better target coverage and better sparing of critical organs. SBRS is used mainly for small non metastatic primary cancer and oligometastases.…”

Section: Discussionmentioning

confidence: 99%

Salvage Stereotactic Body Radiosurgery in the Management of Recurrent Gynecological Cancer

Yazıcı¹

2013

UHOD

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Local tumor persistence in the pelvis is the major cause of death in patients with recurrent gynecological cancer. Pelvic exenteration has been the only treatment option providing a chance for cure in selected patients. The aim of this study is to analyze the efficacy of stereotactic body radiosurgery (SBRS) in patients with recurrent gynecological cancer. Sixteen patients treated with SBRS were analyzed retrospectively. The majority of the patients had cervical cancer. Eleven patients had a history of prior radiotherapy either as postoperative adjuvant external beam radiotherapy (EBRT) with a median dose of 50.4 Gy (range 45-60 Gy) or definitive chemoradiotherapy as EBRT and high dose rate brachytherapy with a dose of 85-90 Gy low dose rate equivalent to point A. The prescribed dose of SBRS was 15-40 Gy (mean 26.6 Gy) in 3-5 fractions. Five patients with no prior radiotherapy received additional EBRT before SBRS. The median follow-up in all patients is 12 months (range 3-36 months). Six patients (37.5%) showed complete radiological and functional response to salvage SBRS. Six patients (37.5%) showed partial response and 2 (12.5%) showed stable disease. One and 2 year overall survival rates are 60.3% and 40.2% respectively. Progression free survival is 59%. All patients with complete response after SBRS are alive with no evidence of disease with a median follow up time of 20 months. SBRS is a promising treatment modality with high local control and reasonable complication rates in selected patients with recurrent gynecological cancer.Keywords: Cyberknife, Radiotherapy, Recurrent gynecological cancer, Salvage, Stereotactic radiosurgery ÖZET Rekürren Jinekolojik Kanser Tedavisinde Kurtarma Amaçl› Stereotaktik Vücut RadyocerrahisiLokal-bölgesel yineleme gözlenen jinekolojik kanserli hastalarda ölüm nedeni ço¤unlukla bölgesel hastal›kt›r. Seçilmifl grup hastada pelvik ekzenterasyon kür için tek seçenek olmufltur. Bu çal›flman›n amac› stereotaktik vücut radyocerrahisinin (SVRC) reküren jinekolojik kanserli hastalarda etkinli¤ini araflt›rmakt›r. SVRC ile tedavi edilen 16 hasta retrospektif olarak de¤erlendirilmifltir. Hastalar›n bü-yük ço¤unlu¤unun tan›s› serviks kanseridir. On bir hastan›n ilk tedavisinde postoperatif ya da küratif radyoterapi uygulanm›flt›r. SVRC ile reçete edilen doz 15-45 Gy' dir (ortalama 26.6 Gy) ve 3-5 fraksiyonda uygulanm›flt›r. Daha önce radyoterapi uygulanmayan hastalara eksternal tedavi SVRC öncesinde uygulanm›flt›r. Ortanca takip 12 ayd›r (3-36 ay). Alt› hastada (%37.5) radyolojik olarak tam cevap elde edilmifltir. Alt› hastada parsiyel cevap (%37.5) ve iki hastada stabil hastal›k (%12.5) gözlenmifltir. Bir ve 2 y›ll›k genel sa¤ kal›m oranlar› s›ras› ile % 60.3 ve % 40.2' dir. Progresyonsuz sa¤ kal›m % 59' dur. Tam cevap al›nan hastalar›n tamam› ortanca 20 ayl›k takipte hastal›ks›z hayattad›r. SVRC yüksek lokal kontrol oranlar› ve nispeten düflük komplikasyon yüzdesi ile reküren jinekolojik kanserli hastalarda seçilmifl bir grupta iyi bir tedavi seçene¤idir.

show abstract

Comparison of intracavitary brachytherapy and stereotactic body radiotherapy dose distribution for cervical cancer

Cited by 48 publications

References 23 publications

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

External beam techniques to boost cervical cancer when brachytherapy is not an option—theories and applications

Radiotherapy of Cervical Cancer

Salvage Stereotactic Body Radiosurgery in the Management of Recurrent Gynecological Cancer

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