High-tech image-guided therapy versus low-tech, simple, cheap gynecologic brachytherapy

Kirisits, Christian; Schmid, Maximilian; Beriwal, Sushil; Pötter, Richard

doi:10.1016/j.brachy.2015.08.010

Cited by 7 publications

(8 citation statements)

References 19 publications

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“…In the last few years US-based BT dose adaptation has been increasingly investigated for cervical cancer IGABT [33]. US has been proven as an excellent diagnostic imaging modality in gynecological oncology [34] and it has been extensively used during BT application to guide tandem and needles insertion [35].…”

Section: Discussionmentioning

confidence: 99%

“…For all these reasons, Kirisits et al stated, in an interesting editorial, “this method may be useful, mainly in limited size and well-responding tumors, which are confined to the cervix at the time of BT. However, this clinical scenario does not represent most patients in advanced stage as seen in the countries with high patient numbers and limited resources” [33].…”

Section: Discussionmentioning

confidence: 99%

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Prospective intra/inter-observer evaluation of pre-brachytherapy cervical cancer tumor width measured in TRUS and MR imaging

et al. 2019

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Background Ultrasound (US) imaging has been proved as an excellent diagnostic tool in gynecology and, due to its wide availability and limited cost, is under intense investigation as base for dose adaptation in cervical cancer brachytherapy. Purpose of this work is to test inter/intra-observer uncertainties between magnetic resonance (MR) and trans-rectal ultrasound (TRUS) imaging in defining maximum tumor width before first brachytherapy (BT) application in a prospective cohort of cervical cancer patients undergoing image-guided adaptive brachytherapy (IGABT). Methods One hundred ten consecutive cervical cancer patients treated between 2013 and 2016 were included. Before the first BT implant patients underwent MR and TRUS scan with no applicator in place. Images were independently analyzed by three examiners, blinded to the other’s results. With clinical information at hand, maximum tumor width was measured on preBT TRUS and MR. Quantitative agreement analysis was undertaken. Intra-class correlation coefficient (ICC), Passing-Bablok and Bland Altman plots were used to evaluate the intra/inter-observers measurement agreement. Results Average difference between tumor width measured on MR (HRCTVMR) and TRUS (HRCTVTRUS) was 1.3 ± 3.2 mm (p < 0.001); 1.1 ± 4.6 mm (p = 0.01) and 0.7 ± 3 mm (p = 0.01). The error was less than 3 mm in 79, 82 and 80% of the measurements for the three observers, respectively. Intra-observer ICC was 0.96 (CI95% 0.94–0.97), 0.93 (CI95% 0.9–0.95) and 0.96 (CI95% 0.95–0.98) respectively. Inter-observer ICC for HRCTVMR width measures was 0.92 (CI95% 0.89–0.94) with no difference among FIGO stages. Inter-observer ICC for HRCTVTRUS was 0.86 (CI95% 0.81–0.9). For FIGO stage I and II tumors, ICC HRCTVTRUS values were comparable to respective HRCTVMR ICC values. For larger tumors HRCTVTRUS inter-observer ICC values were lower than respective HRCTVMR although remaining acceptable. Conclusions Our results suggest that TRUS is equivalent to MR in assessing preBT tumor maximum width in cervical cancer FIGO stage I/II. In more advanced stages TRUS seems to be slightly inferior to MR although maintaining a good agreement to gold standard imaging.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prospective intra/inter-observer evaluation of pre-brachytherapy cervical cancer tumor width measured in TRUS and MR imaging

et al. 2019

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“…A possible limitation of the present study is that it was initiated before the availability of modern image-guided techniques (23), which have proved useful and now include ultrasound (24). In the study by P€ otter et al (25), 33 patients with FIGO Stage IIIB disease received HDR 192 Ir BT in conjunction with 4-field EBRT þ/À cisplatin chemotherapy.…”

Section: Discussionmentioning

confidence: 96%

Long-term results for Stage IIIB cervical cancer patients receiving external beam radiotherapy combined with either HDR 252Cf or HDR 60Co intracavitary brachytherapy

et al. 2016

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“…According to an analysis of the National Cancer Data, use of BT in the treatment of cervical cancer in the USA has decreased, while at the same time, use of IMRT and SBRT increased significantly between 2004 and 2011, and the IMRT or SBRT boost resulted in poorer overall survival compared to BT [ 2 ]. As the physical dose distribution of intracavitary and interstitial BT for the cervix is optimal, and imaging techniques for 3D planning are becoming increasingly available, this technique must be made widely available worldwide [ 15 ].…”

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confidence: 99%

The value of brachytherapy in the age of advanced external beam radiotherapy: a review of the literature in terms of dosimetry

et al. 2021

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Brachytherapy (BT) has long been used for successful treatment of various tumour entities, including prostate, breast and gynaecological cancer. However, particularly due to advances in modern external beam techniques such as intensity-modulated radiotherapy (IMRT), volume modulated arc therapy (VMAT) and stereotactic body radiotherapy (SBRT), there are concerns about its future. Based on a comprehensive literature review, this article aims to summarize the role of BT in cancer treatment and highlight its particular dosimetric advantages. The authors conclude that image-guided BT supported by inverse dose planning will successfully compete with high-tech EBRT in the future and continue to serve as a valuable modality for cancer treatment.

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High-tech image-guided therapy versus low-tech, simple, cheap gynecologic brachytherapy

Cited by 7 publications

References 19 publications

Prospective intra/inter-observer evaluation of pre-brachytherapy cervical cancer tumor width measured in TRUS and MR imaging

Prospective intra/inter-observer evaluation of pre-brachytherapy cervical cancer tumor width measured in TRUS and MR imaging

Long-term results for Stage IIIB cervical cancer patients receiving external beam radiotherapy combined with either HDR 252Cf or HDR 60Co intracavitary brachytherapy

The value of brachytherapy in the age of advanced external beam radiotherapy: a review of the literature in terms of dosimetry

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