Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy

Rijkmans, E.C.; Nout, Remi A.; Rutten, Isabelle; Ketelaars, M.; Neelis, Karen J.; Laman, M.S.; Coen, V.; Gaarenstroom, Katja N.; Kroep, Judith R.; Creutzberg, Carien L.

doi:10.1016/j.ygyno.2014.08.027

Cited by 209 publications

(131 citation statements)

References 29 publications

(38 reference statements)

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“…Mature clinical outcome on recurrence and toxicity was reported by the gynecological cancers treated with a combination of EBRT and BT [23,[25][26][27][28][29][30][32][33][34][35][36][37][38][39] as well as from the large prostate trial conducted at Beaumont [12,[14][15][16]. For the gynecological cancers and most pronounced for the advanced stages, the improved target coverage obtained through ART has improved local control [37].…”

Section: Discussionmentioning

confidence: 99%

“…For the gynecological cancers and most pronounced for the advanced stages, the improved target coverage obtained through ART has improved local control [37]. In addition, a decrease in complications has been reported by patients receiving BT with ART in comparison with the old method of treatment delivery [27,29,37,38]. These encouraging results from following the Gynecological GEC-ESTRO recommendations [42,43] has also led to patients previously appointed to hysterectomy now being considered for BT [30].…”

Section: Discussionmentioning

confidence: 99%

“…For gynecological tumor sites ART implementations had been used since 1993 for treatment of in total of 1409 patients at 10 institutions and one multi-center study (Table 3) [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]. All but four studies focused on cervical cancer, most commonly staged as FIGO IIB.…”

Section: Gynecological Cancermentioning

confidence: 99%

“…The BT was adapted through online re-planning prescribing different dose levels to each adapted risk volume and allowing an individual dose escalation bounded by the recommended OAR doses [42][43][44]. Twelve studies have so far reported their experience and outcomes after clinical implementation according to these recommendations (Table 3) [29][30][31][32][33][34][35][36][37][38][39][40], 10 of which focused solely on cervical cancer [29][30][31][34][35][36][37][38][39][40]. The majority (674/871) of the cervical cancer patients underwent EBRT combined with 1-3 fractions of pulsed-dose-rate (PDR) BT, 151 patients received EBRT and high-dose-rate (HDR) BT and 46 patients EBRT in addition to a combination of PDR and HDR (Table 3) [29][30][31][34][35][36][37][38][39][40].…”

Section: Online Re-plan Using the Gec-estro Recommendations For Adaptmentioning

confidence: 99%

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Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Gynecological Cancermentioning

confidence: 99%

Section: Online Re-plan Using the Gec-estro Recommendations For Adaptmentioning

confidence: 99%

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Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

et al. 2016

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“…Recent comparisons of conventional 2D (x-ray, point A based) brachytherapy and 3D (MRI, CT) IGABT in cervical cancer showed correspondingly even larger improvements, e.g. 16-35% increase in local tumor control and overall survival in mono-institutional cohorts compared to historical treatment [28,29] and 50% reduction of side effects by IGABT in a prospective comparative study [30].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of planning aims and dose prescription in image-guided adaptive brachytherapy and radiochemotherapy for cervical cancer: Vienna clinical experience in 225 patients from 1998 to 2008

et al. 2015

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Results . In the PA ϩ group there were 77 (34%) and in the PA-group 148 (66%) patients. In the PA-group, CTV HR D 90 Ͻ 85 Gy was prescribed in 82 patients, D 2cm3 bladder Ͼ 90 Gy was prescribed in 80 patients and D 2cm3 Rectum Ͼ 70 Gy in 60 patients. Fulfi llment of the PA for dose prescription improved from 4% in the learning period to 48% in the protocol period. The fi ve-year event-free interval was 64% in the learning period and 84% in the protocol period (p ϭ 0.008). Conclusion . Fulfi llment of all PAs for dose prescription is challenging -especially in patients with more advanced tumors. However, with growing experience fulfi llment of PA for dose prescription can be signifi cantly increased (learning and protocol period). Such increase in fulfi lling PA for dose prescription is followed by a signifi cant improvement in clinical outcome.The gold standard in the treatment of locally advanced cervix cancer is radio-chemotherapy and brachytherapy [1]. Image-guided adaptive brachytherapy (IGABT) is an advanced method which is increasingly implemented in clinical practice [2,3]. By imaging of the applicator and tumor/target volume and the surrounding organs at risk (OAR), IGABT offers the possibility of dose optimization based on the individual high risk (HR) clinical target volumes (CTV) and OARs [4 -7]. First clinical results indicate a reduction in local recurrence and side effects in comparison to standard point A based brachytherapy [8 -11]. Recently, dose response relationships were described in IGABT for the target volume and OARs (bladder and rectum) based on the monoinstitutional Vienna cohort and also based on the large multi-center cohort RetroEMBRACE [12 -15].

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Neoplasms of the Cervix

Jhingran¹

2022

Holland‐Frei Cancer Medicine

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Overview Cervical cancer is the third most common cancer among women worldwide and the fourth leading cause of female cancer deaths, with an estimated 529,800 new cases and 275,100 deaths in the year 2008. The incidence is declining in the United States with 13,800 new cases and 4290 deaths in 2015. Squamous cell carcinoma is the most common histology with the human papilloma virus being the most common etiology. Cervical cancer and precancer can be easily detected with pap smears and HPV testing and prevented with HPV vaccine. Early‐stage cervix cancer can be treated with surgery including now fertility‐sparing surgery and there are high cure rates. Locally advanced cervical cancer is treated with combination of chemotherapy and radiation therapy with high survival rates but there is room for improvement with advancing stage. Systemic chemotherapy can be used for treatment of both recurrent and metastatic disease, but careful attention should be paid to balancing benefit and toxicity. The key to improving overall outcomes will be translating the success seen in developed countries to areas of the world where advanced‐stage invasive cervical cancer is most common.

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Improved survival of patients with cervical cancer treated with image-guided brachytherapy compared with conventional brachytherapy

Cited by 209 publications

References 29 publications

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

Evaluation of planning aims and dose prescription in image-guided adaptive brachytherapy and radiochemotherapy for cervical cancer: Vienna clinical experience in 225 patients from 1998 to 2008

Neoplasms of the Cervix

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