Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study

Sturdza, Alina; Pötter, Richard; Fokdal, Lars; Haie-Méder, Christine; Tan, Li Tee; Mazeron, R.; Petrič, Primož; Šegedin, Barbara; Jürgenliemk-Schulz, Ina M.; Nomden, C.N.; Gillham, Charles; McArdle, O.; Limbergen, Erik; Janssen, Hilde; Hoskin, Peter; Lowe, Gerry; Tharavichitkul, Ekkasit; Villafranca, E.; Mahantshetty, Umesh; Georg, Petra; Kirchheiner, Kathrin; Kirisits, Christian; Tanderup, Kari; Lindegaard, Jacob Christian

doi:10.1016/j.radonc.2016.03.011

Cited by 555 publications

(524 citation statements)

References 29 publications

Supporting

Mentioning

461

Contrasting

Unclassified

Order By: Relevance

“…There are an increasing number of published reports regarding treatment results of IGABT for cervical cancer as shown in Table 4 [8][9][10][11][12][14][15][16][17]. In 2011, Pötter et al retrospectively analyzed 156 patients with FIGO stage IB to IVA cervical cancer treated by IGABT at Medical University of Vienna [8].…”

Section: Reported Treatment Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Yoshida¹,

Nishikawa²,

Miyawaki³

et al. 2017

Radiotherapy

View full text Add to dashboard Cite

Image-guided adaptive brachytherapy (IGABT) using magnetic resonance imaging (MRI) has been accepted as a novel treatment technique for cervical cancer. During the development of MRI-based IGABT, a very important concept called "High-risk clinical target volume (HR-CTV)" was introduced. However, computed tomography (CT)-based IGABT is the most common modality in Japan.MRI-based IGABT was initiated in September 2014 at Kobe University Hospital and 50 patients were treated through March 2016. Although a total HR-CTV D90 ranging from 80 to 85 Gy equivalent dose in 2 Gy fractions in combination with 45 Gy of external beam radiotherapy (EBRT) and 7 Gy×4 fractions of IGABT is the most standard treatment aim in European institutions, our aim for a total HR-CTV D90 was a 70-80 Gy because of the use of the central shielding technique for the protection of organs at risk in the late phase of EBRT.The mean total HR-CTV D90 for our 50 patients was 77 Gy. Although our aim was achieved, it was relatively low because Japanese radiotherapy protocols for cervical cancer still differ from those in European institutions. Therefore, a new treatment protocol, which is closer to the global standard, should be established.

show abstract

Section: Reported Treatment Resultsmentioning

confidence: 99%

“…In a recent large multicenter study called RetroEMBRACE, Sturdza et al analyzed 731 patients [17]. They reported that three-year overall survival rates for stage IB, IIB, and IIIB patients were 88, 78, and 56%, respectively.…”

Section: Reported Treatment Resultsmentioning

confidence: 99%

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Yoshida¹,

Nishikawa²,

Miyawaki³

et al. 2017

Radiotherapy

View full text Add to dashboard Cite

show abstract

“…Показатели безрецидивной выживаемости в зависимо-сти от стадии заболевания составляют 92-98, 60-82 и 25-37% при I, II и III-IVА ста-диях РШМ соответственно [7,8].…”

Section: Combinedunclassified

Сombined radiotherapy for cervical cancer with the use of polyradiosensitization with cisplatin and gemcitabine - immediate trial results of Azerbaijan national center of oncology

Aliyev¹,

Isayev²,

Akbarov³

et al. 2017

Kazan Med J

View full text Add to dashboard Cite

Aim. Study of immediate results of chemoradiotherapy of locally advanced cervical cancer with the use of polyradiosensitization with cisplatin and gemcitabine. Methods. The article analyzes diagnostic and treatment results of 128 patients with IIA-IIIB stage cervical cancer. The age of patients varied between 31 and 76 years. External beam radiotherapy was performed with 1.8 Gy fraction up to a total dose of 45 Gy, high dose rate brachytherapy consisted of four 7.0 Gy fractions. Patients from group 1 received weekly infusions of cisplatin (40 mg/m2) and from group 2 - polyradiosensitization with cisplatin (40 mg/m2) and gemcitabine (75 mg/m2). Results. Chemoradiotherapy with the use of polyradiosensitization compared to standard chemoradiotherapy allowed significant improving of immediate results of treatment of patients with locally advanced cervical cancer, which was particularly prominent in such unfavorable cases as cervical adenocarcinoma and IIIB stage of the disease. Early toxicity of the treatment was higher in group 2 but effectively resolved with symptomatic supportive treatment and did not lead to interruptions in radiotherapy. Conclusion. Combination of conformal external beam radiotherapy, high dose rate intracavitary brachytherapy and concurrent polychemotherapy with cisplatin and gemcitabine is feasible and reasonably safe; chemoradiotherapy with the use of polyradiosensitization improves immediate results of the treatment of cervical cancer with acceptable level of toxicity.

show abstract

“…Recently, 3D image-guided brachytherapy (IGBT), which uses computed tomography (CT) or magnetic resonance imaging (MRI) to obtain images of inserted applicators, has come into widespread use (4)(5)(6). The present study reports the use of BT in a patient with locally advanced cervical cancer involving a complete septate uterus with right and left uterine canals.…”

Section: Introductionmentioning

confidence: 98%

Brachytherapy for cervical cancer in septate uterus: Dose-volume differences with tandem implant placement in right vs. left uterine canal: A case report

et al. 2018

View full text Add to dashboard Cite

Abstract. Brachytherapy is a standard treatment modality for locally advanced cervical cancer. In patients with uterine anomalies, the radiation dose to the target volume and the organs at risk can vary depending on the positioning of the brachytherapy tandem implant. However, there have been few reports concerning the use of brachytherapy in patients with uterine anomalies. The present study reports the case of a 55-year-old woman with locally advanced squamous cell carcinoma of the cervix and complete septate uterus. The patient was treated with external-beam radiation therapy, cisplatin chemotherapy, and brachytherapy. Computed tomography-based planning was performed for image-guided brachytherapy with the tandem implant alternately in the right and left uterine canals and using the right and left point A. A comparison of the resulting dose-volume histograms revealed wide variations in the projected dose to the clinical target volume and organs at risk. Tandem implant positioning for brachytherapy was chosen to optimize the dose-volume distribution. At the point of writing, the patient has not experienced local recurrence. IntroductionThe standard treatment for locally advanced cervical cancer is pelvic external beam radiation therapy (EBRT) with concurrent cisplatin chemotherapy and brachytherapy (BT) (1-3).Recently, 3D image-guided brachytherapy (IGBT), which uses computed tomography (CT) or magnetic resonance imaging (MRI) to obtain images of inserted applicators, has come into widespread use (4-6). The present study reports the use of BT in a patient with locally advanced cervical cancer involving a complete septate uterus with right and left uterine canals. Prior to treatment, CT images were obtained with a tandem implant inserted alternately into the right and left uterine canals. A treatment-planning system was used to compare the resulting dose volumes; the uterine canal that was associated with optimal distribution of the dose volume was chosen for BT. There have been only a few reports of BT in patients with uterine anomalies. To the best of our knowledge, this is the first case in which the dose-volume difference between tandem implant placement in the right versus left uterine canal was examined. Case report Patient presentation and diagnosis.A 55-year-old woman presented with a 1-month history of general malaise. A high creatinine level of 2.26 mg/dl (normal range, 0.46-0.79 mg/dl) was found upon hematological examination; CT revealed that a cervical tumor was causing bilateral hydronephrosis involving the bilateral ureters. Therefore, bilateral ureteral stents were inserted. Tissue biopsy of the cervical tumor led to a diagnosis of squamous cell carcinoma. MRI revealed that the endometrial cavity was separated into right and left canals by a septum on the cranial side of the cervical tumor (Fig. 1A and B). The septum reached the level of the internal cervical os, indicating a complete septate uterus corresponding to class V of the American Society of Reproductive Medicine classification (7) and ...

show abstract

Image guided brachytherapy in locally advanced cervical cancer: Improved pelvic control and survival in RetroEMBRACE, a multicenter cohort study

Cited by 555 publications

References 29 publications

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Image‐Guided Adaptive Brachytherapy for Cervical Cancer Using Magnetic Resonance Imaging: Overview and Experience

Сombined radiotherapy for cervical cancer with the use of polyradiosensitization with cisplatin and gemcitabine - immediate trial results of Azerbaijan national center of oncology

Brachytherapy for cervical cancer in septate uterus: Dose-volume differences with tandem implant placement in right vs. left uterine canal: A case report

Contact Info

Product

Resources

About