Imaging Technologies for High Dose Rate Brachytherapy for Cervical Cancer: A Systematic Review

D’Souza, David; Baldassarre, Fulvia; Morton, Gerard; Falkson, Conrad; Batchelar, D.

doi:10.1016/j.clon.2011.02.014

Cited by 13 publications

(10 citation statements)

References 31 publications

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“…Compared with point 2D parameters, such as point A and point B, dose–volume histogram (DVH) parameters with the effective visualization of target volumes and OAR were considered to be more accurate for dose assessment in 3D BT . Furthermore, some DVH parameters, such as D 90 ‐HR CTV (the dose covering 90% of the high‐risk clinical target volume) for tumors and D 2cc (the minimum dose in the 2cc most irradiated tissue volume) for OAR, have been demonstrated to be predictive of the tumor control probability and occurrence of LSE for OAR .…”

Section: Introductionmentioning

confidence: 99%

Late rectal toxicity determined by dose–volume parameters in computed tomography‐based brachytherapy for locally advanced cervical cancer

et al. 2016

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The aim of this study was to observe the relationship between dose–volume histogram (DVH) parameters and rectal late side effects (LSE) in computed tomography (CT)‐based brachytherapy (BT) for patients with locally advanced cervical cancer. In total, 144 cervical cancer patients received external beam radiotherapy and CT‐based BT. The data from 111 survival cases with pelvic local control (LC) were used to analyze the relationship between DVH parameters and rectal LSE. The total doses, manifesting 2, 1, and 0.1 cm3 (D2cc, D1cc, and D0.1cc) of the rectum, and D90 for high‐risk clinical target volume (HR CTV) were computed and normalized to 2 Gy fractions (EQD2) using a linear‐quadratic model. The rectal LSE were evaluated by the late effects in normal tissues‐subjective, objective, management, and analytic (LENT‐SOMA) scale. A dose–response relationship was evaluated by probit analyses. For all patients, the total rate of rectal LSE was 56%, and the rate of ≥Grade 2 LSE was 27.4%. For the 111 survival cases with pelvic LC, the total mean for D2cc was 71.23 ± 5.54 Gy for the rectum, and the D2cc, D1cc, and D0.1cc values for Grades 2 and 3 were higher than those for Grades 0 and 1. In addition, the number of complications increased, and the complications became more severe as the dose increased, with a dose of 73.5 Gy resulting in a 10% probability of ≥Grade 3 LSE. In conclusion, DVH parameters could predict the incidence and grades of rectal LSE in CT‐based BT. D2cc showed an excellent predictive value, and 73.5 Gy for D2cc of the rectum might be considered as an alternative dose limit.

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Section: Introductionmentioning

confidence: 99%

Late rectal toxicity determined by dose–volume parameters in computed tomography‐based brachytherapy for locally advanced cervical cancer

et al. 2016

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“…Furthermore, compared with CT image guidance, MR image guidance is associated with greater accuracy in evaluating tumor infiltration into parametria and clearer soft tissue delineation between cervix, uterus and vagina. 31 Similarly, at our institution, like many centers across the country, we are transitioning our practice into 3-dimension image-based brachytherapy from orthogonal imaging for treatment planning. This would potentially allow for better tumor delineation with dosimetric parameters as outlined in guidelines by The Groupe Européen de Curiethérapie and the European SocieTy for Radiotherapy & Oncology working group.…”

Section: Discussionmentioning

confidence: 99%

The Impact of High-Dose-Rate Brachytherapy: Measuring Clinical Outcomes in the Primary Treatment of Cervical Cancer

Song

Alyamani

Bhattacharya

et al. 2020

Advances in Radiation Oncology

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Radical concurrent chemoradiotherapy with combined external beam radiotherapy (EBRT) and brachytherapy is used to treat locally advanced cervical cancer. Our institution has transitioned to high-dose-rate (HDR) intracavitary brachytherapy (ICBT) from lowdose-rate (LDR) brachytherapy in 2008, and a review was conducted on the effect of this change on patient outcomes. Methods and Materials: A single-arm retrospective chart review was performed on locally advanced (Fédération Internationale de Gynécologie et d'Obstétrique stage IB-IVA) patients with cervical cancer treated with combined external beam radiation therapy and HDR-ICBT with curative intent between 2008 and 2014. Clinical outcomes were evaluated, and multivariate analysis was performed to identify prognostic factors. Results: Of the 76 patients selected, median age was 47.9 years and median follow-up was 5.2 years. Thirteen patients (17.1%) developed locoregional recurrence and 23 patients (30.3%) patients developed distant recurrence. Five-year progression-free survival and overall survival were 63.7% and 69.3%, respectively. A significant survival difference was found between stages (P < .001). Multivariate analysis found nodal involvement was strongly associated with poorer survival (P Z .007). Conclusions: Our experience with the transition to HDR-ICBT as part of concurrent chemoradiotherapy in treatment of locally advanced cervical cancer resulted in acceptable long-term outcomes and toxicity to that of LDR brachytherapy. Potential further improvement of treatment outcomes for patients may be possible with image guided brachytherapy and the addition of effective systemic therapy.

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“…; and (iii) outcome data: BT parameters, HR‐CTV dose, dose parameters for OAR, survival rates. Because no validated tool exists for assessing the quality of studies that evaluate imaging technologies, we searched the references and adopted the previously used methods assessing the quality of included studies via several questions . The four parameters used to evaluate the studies are as follows: Was the cohort of patients in the study representative of the patients who will receive the treatment in practice? Have the authors described the procedure in enough detail so that it can be reproduced? Was a statistical test comparing the imaging technologies reported? Is the study prospective? …”

Section: Methodsmentioning

confidence: 99%

Comparison of accuracy and long‐term prognosis between computed tomography‐based and magnetic resonance imaging‐based brachytherapy for cervical cancer: A meta‐analysis

et al. 2019

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High-dose-rate brachytherapy (HDR-BT) has been shown to play an important role in the treatment of cervical cancer patients. The aim of this systematic review and meta-analysis was to compare the dose parameters and long-term effects of MRI-based, CT-based and hybrid imaging (MRI/CT)-based volumetric planning. A systematic search was conducted to identify the clinical studies of BT treatment on cervical cancer patients. After study selection, a total of 13 clinical studies were enrolled for further analysis. No obvious differences were observed among the treatment parameters and the patients included. In detail, no significant difference was observed among these three techniques of volumetric planning in the parameters of high-risk clinical target volume (HR-CTV), total dose of D90 or mean fraction dose of D90. Meanwhile, MRIbased planning was superior to CT-based treatment in the total dose D2cc to organs at risk (OAR) for the bladder, rectum and sigmoid. Furthermore, no significant difference was observed among MRI-, CT-or hybrid-based treatments with the mean fraction dose D2cc to OAR for the bladder, rectum or sigmoid. In conclusion, MRI provides good anatomical delineation of the relevant HR-CTV and OAR, and performed better in the analyses of dose parameters compared with CT. At least one MR image is required to assess the tumour extension, with clinical findings and MRI information facilitating much more accurate CT-based contouring.

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Imaging Technologies for High Dose Rate Brachytherapy for Cervical Cancer: A Systematic Review

Cited by 13 publications

References 31 publications

Late rectal toxicity determined by dose–volume parameters in computed tomography‐based brachytherapy for locally advanced cervical cancer

Late rectal toxicity determined by dose–volume parameters in computed tomography‐based brachytherapy for locally advanced cervical cancer

The Impact of High-Dose-Rate Brachytherapy: Measuring Clinical Outcomes in the Primary Treatment of Cervical Cancer

Comparison of accuracy and long‐term prognosis between computed tomography‐based and magnetic resonance imaging‐based brachytherapy for cervical cancer: A meta‐analysis

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