Intensity-Modulated Arc Therapy with Simultaneous Integrated Boost in the Treatment of Primary Irresectable Cervical Cancer

Vandecasteele, Katrien; Neve, Wilfried De; Gersem, Werner De; Delrue, Louke; Paelinck, Leen; Makar, Amin; Fonteyne, Valérie; Wagter, Carlos De; Villeirs, Geert; Meerleer, Gert De

doi:10.1007/s00066-009-1986-8

Cited by 57 publications

(58 citation statements)

References 51 publications

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“…Four pa- [25]. PET-positive lymph node(s) were delineated separately (GTV_ nodes) [26]. Dose prescription (25 fractions) were as follows: D50 of 62, 58 and 56 Gy to the GTV_cer-vix, CTV_cervix and PTV_cervix respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, IMRT might allow replacing the brachytherapeutic boost by a simultaneous integrated boost (SIB) and consequently reduces treatment time, the latter being strongly correlated with local control and survival [11]. The rationale and clinical implementation of intensity-modulated arc therapy (IMAT) in this setting has been described in detail before [26].…”

Section: Intensity-modulated Arc Therapy With Cisplatin As Neo-adjuvamentioning

confidence: 99%

“…IMAT was delivered using 18-MV photons of an Elekta SL18 series Linear Accelerator (SliPlus, Elekta, Crawley, UK) equipped with a standard multileaf collimator (MLC) and prototype dynamic control software to deliver IMAT in local service mode [7]. The IMAT plans were generated using an anatomy-based exclusion tool with the aid of weight and leaf position optimisation [7,26]. Patient positioning was verified online using an electronic portal imaging device (EPID) [26].…”

Section: Imat ± Cisplatinmentioning

confidence: 99%

“…The IMAT plans were generated using an anatomy-based exclusion tool with the aid of weight and leaf position optimisation [7,26]. Patient positioning was verified online using an electronic portal imaging device (EPID) [26].…”

Section: Imat ± Cisplatinmentioning

confidence: 99%

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Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer

et al. 2012

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Section: Resultsmentioning

confidence: 99%

Section: Intensity-modulated Arc Therapy With Cisplatin As Neo-adjuvamentioning

confidence: 99%

Section: Imat ± Cisplatinmentioning

confidence: 99%

Section: Imat ± Cisplatinmentioning

confidence: 99%

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Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer

et al. 2012

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“…Intensity-modulated radiotherapy (IMRT) significantly reduces acute and late toxicity to the organs at risk [5,21,24,25,27,[33][34][35]. This makes dose escalation possible without increasing GI and GU toxicities.…”

Section: Introductionmentioning

confidence: 99%

Helical Tomotherapy in Cervical Cancer Patients

et al. 2010

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Immunologic impact of chemoradiation in cervical cancer and how immune cell infiltration could lead toward personalized treatment

Lippens

Bockstal

Jaeghere

et al. 2020

Intl Journal of Cancer

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We investigated the potential of tumor-infiltrating immune cells (ICs) as predictive or prognostic biomarkers for cervical cancer patients. In total, 38 patients treated with (chemo)radiotherapy and subsequent surgery were included in the current study. This unique treatment schedule makes it possible to analyze IC markers in pretreatment and posttreatment tissue specimens and their changes during treatment. IC markers for T cells (CD3, CD4, CD8 and FoxP3), macrophages (CD68 and CD163) and B cells (CD20), as well as IL33 and PD-L1, were retrospectively analyzed via immunohistochemistry. Patients were grouped in the low score or high score group based on the amount of positive cells on immunohistochemistry. Correlations to pathological complete response (pCR), cause-specific survival (CSS) and metastasis development during follow-up were evaluated. In analysis of pretreatment biopsies, significantly more pCR was seen for patients with CD8 = CD3, CD8 ≥ CD4, positive IL33 tumor cell (TC) scores, IL33 IC < TC and PD-L1 TC ≥5%. Besides patients with high CD8 scores, also patients with CD8 ≥ CD4, CD163 ≥ CD68 or PD-L1 IC ≥5% had better CSS. In the analysis of posttreatment specimens, less pCR was observed for patients with high CD8 or CD163 scores. Patients with decreasing CD8 or CD163 scores between pretreatment and posttreatment samples showed more pCR, whereas those with increasing CD8 or decreasing IL33 IC scores showed a worse CSS. Meanwhile, patients with an increasing CD3 score or stable/increasing PD-L1 IC score showed more metastasis during follow-up. In this way, the intratumoral IC landscape is a promising tool for prediction of outcome and response to (chemo)radiotherapy.K.V. and H.D. contributed equally to this work Additional Supporting Information may be found in the online version of this article.

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Intensity-Modulated Arc Therapy with Simultaneous Integrated Boost in the Treatment of Primary Irresectable Cervical Cancer

Abstract: IMAT allows delivering an SIB to the macroscopic tumor without compromising the dose to the elective lymph nodes or the organs at risk. The clinical implementation is feasible.

Cited by 57 publications

References 51 publications

Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer

Intensity-modulated arc therapy with cisplatin as neo-adjuvant treatment for primary irresectable cervical cancer

Helical Tomotherapy in Cervical Cancer Patients

Immunologic impact of chemoradiation in cervical cancer and how immune cell infiltration could lead toward personalized treatment

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